Mid Illini Non Emergency Patient Transport LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

MID ILLINI NON EMERGENCY PATIENT TRANSPORT LLC

Practice address

3700 N Main St
East Peoria, IL 61611-1447

Phone

(309) 840-4503

NPI assigned

Dec 26, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeramy Doerr

Title

Owner

Phone

(309) 840-4503

Specialties & licenses 1

Addresses

Other names 1

• ILLINI NON EMERGENCY PATIENT TRANSP Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1700599552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 589",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424315011",
            "telephone_number": "270-824-8123",
            "fax_number": "270-824-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N MAIN ST",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111447",
            "telephone_number": "309-840-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ILLINI NON EMERGENCY PATIENT TRANSPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-26",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "DOERR",
        "authorized_official_first_name": "JERAMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-840-4503"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ILLINI NON EMERGENCY PATIENT TRANSP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittany Anne McGill, APRN, CNP
• Sean M McGinn, O.T.
• Linda McGrew
• Lillian Merchant-Sullivan, PHD LCPC
• Christy Metzger
• Midwest Children'S Therapy, PLLC
• Lauren Nicole Miklavcic, PHARMD
• Kent Eugene Miller, M.D.
• Sarah L Morrell, L.M.T.
• Sarah Mosier

• Land Ambulance in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.