Active NPI
Katelynn Madden, APRN, CNS
- Gerontology Clinical Nurse Specialist
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Clinical Nurse Specialist
- License
- 209022044
- Practice address
- 1001 Main St Ste 200
Peoria, IL 61606-2035 - Phone
- (309) 672-5682
- Fax
- (309) 672-3147
- NPI assigned
- Sep 21, 2020
- Last updated
- Sep 22, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 209.022044 | IL | |
| Gerontology Clinical Nurse Specialist | 364SG0600X | 209022044 | IL | Primary |
Addresses
Primary practice location
1001 Main St Ste 200
Peoria, IL 61606-2035
Mailing address
305 E Monroe St
Metamora, IL 61548-7115
Phone (309) 696-8183
Other practice location 1
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209022044 | Other | IL | APN LICENSE |
Other names 1
- Katelynn Davis
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Metamora | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Clinical Nurse Specialist (CNS)
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1001 Main St
Suite 200
Peoria, IL 61606-2035
Phone (309) 672-5682
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.022044 | IL | MD | Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients |
Locations
1001 Main St
Ste 200
Peoria, IL 61606
Phone (309) 308-2010
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758499200000",
"number": "1720694094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 E MONROE ST",
"city": "METAMORA",
"state": "IL",
"postal_code": "615487115",
"telephone_number": "309-696-8183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 MAIN ST STE 200",
"city": "PEORIA",
"state": "IL",
"postal_code": "616062035",
"telephone_number": "309-672-5682",
"fax_number": "309-672-3147"
}
],
"practiceLocations": [
{
"address_1": "530 NE Glen Oak Ave",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "IL",
"postal_code": "616370001",
"country_code": "US",
"telephone_number": "309-655-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MADDEN",
"first_name": "KATELYNN",
"credential": "APRN, CNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-21",
"last_updated": "2025-09-22",
"certification_date": "2025-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "IL",
"license": "209.022044",
"primary": false
},
{
"code": "364SG0600X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Gerontology",
"state": "IL",
"license": "209022044",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APN LICENSE",
"identifier": "209022044",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Metamora",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "530 NE Glen Oak Ave",
"city": "Peoria",
"state": "IL",
"country_code": "US",
"postal_code": "616370001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KATELYNN",
"last_name": "DAVIS",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.