Individual provider Active NPI

Diane Anderton, DNP

  • Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1760124663
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209024993 Issued in IL
Practice address
3626 W Chartwell Rd
Peoria, IL 61614-8123
Phone
(309) 678-6608
NPI assigned
Apr 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209024993 IL Primary

Addresses

Primary practice location

3626 W Chartwell Rd
Peoria, IL 61614-8123

Mailing address

3626 W Chartwell Rd
Peoria, IL 61614-8123
Phone (309) 678-6608

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
I20220721001652 IL Practitioner - Nurse Practitioner 9133500168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
73.52 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
40
Cost
78.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209024993ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Solutions, SC CurrentSince Oct 1, 2022 Accepting new patients

Locations

1 Westbrook Corporate Ctr
Ste 300
Westchester, IL 60154
Phone (630) 709-1501

39465 W 14 Mile Rd
Novi, MI 48377
Phone 24885939000

Organizations & group practices 1

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": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1760124663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 W CHARTWELL RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148123",
            "telephone_number": "309-678-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 W CHARTWELL RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148123",
            "telephone_number": "309-678-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERTON",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209024993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.