NPIMap

Individual provider Active NPI

Julie Ann Threadgill, APRN,CNP

  • Family Nurse Practitioner
  • Ottawa, IL
National Provider Identifier
1770360422
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209028334 Issued in IL
Practice address
1614 E Norris Dr
Ottawa, IL 61350-3681
Phone
(815) 433-1010
NPI assigned
Sep 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 41442787 IL
Family Nurse Practitioner 363LF0000X 209028334 IL Primary

Addresses

Primary practice location

1614 E Norris Dr
Ottawa, IL 61350-3681

Mailing address

1614 E Norris Dr
Ottawa, IL 61350-3681
Phone (815) 433-1010

Other practice location 1

111 Spring St
Streator, IL 61364-3332
Phone (815) 672-4587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231214002664 IL Practitioner - Nurse Practitioner 3173972262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint James HospitalGroup PAC ID 0648187252, 74 clinicians

Practice addresses (Care Compare)

111 Spring St
FL 4
Streator, IL 61364-3332
Phone (815) 672-4587

1614 E Norris Dr
Osf Healthcare Medical Group Ottawa
Ottawa, IL 61350-3681
Phone (815) 433-1010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
41442787ILMDInternal Medicine Physician
209028334ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint James Hospital CurrentSince Dec 1, 2023 Accepting new patients
Ottawa Regional Hospital & Healthcare Center Current Accepting new patients
Saint James Hospital CurrentSince Dec 1, 2023 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Dec 1, 2023 Accepting new patients
Ottawa Regional Hospital & Healthcare Center Past Accepting new patients
Saint James Hospital Past Accepting new patients

Locations

1640 1st Ave
Ottawa, IL 61350
Phone (815) 431-9208

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

1614 E Norris Dr
Ottawa, IL 61350
Phone (815) 433-1010

111 Spring St
Streator, IL 61364
Phone (815) 672-4587

111 Spring St
Fl 4
Streator, IL 61364
Phone (815) 672-4587

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1770360422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503681",
            "telephone_number": "815-433-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503681",
            "telephone_number": "815-433-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Spring St",
            "address_purpose": "LOCATION",
            "city": "Streator",
            "state": "IL",
            "postal_code": "613643332",
            "country_code": "US",
            "telephone_number": "815-672-4587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THREADGILL",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "41442787",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

Verify at the official NPI Registry.