Individual provider Active NPI

Cassandra Worrick, FNP

  • General Practice Physician
  • Peoria, IL
National Provider Identifier
1720752074
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
209022733 Issued in IL
Practice address
8914 N Praire Pointe
Peoria, IL 61615
Phone
(877) 726-6494
NPI assigned
Aug 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 209022733 IL Primary

Addresses

Primary practice location

8914 N Praire Pointe
Peoria, IL 61615

Mailing address

12 Clarebrook Dr
Washington, IL 61571-9216
Phone (309) 369-3786

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221012001617 IL Practitioner - Nurse Practitioner 3173999430 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jul 1, 2022 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jul 1, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1720752074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CLAREBROOK DR",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719216",
            "telephone_number": "309-369-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8914 N PRAIRE POINTE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "877-726-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORRICK",
        "first_name": "CASSANDRA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "209022733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.