Individual provider Active NPI

Sharon A Austin, CNP

  • Family Nurse Practitioner
  • Minonk, IL
National Provider Identifier
1780669309
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
309000390 Issued in IL
Practice address
200 E 6TH St
Minonk, IL 61760-1308
Phone
(309) 432-2441
Fax
(309) 432-3711
NPI assigned
Dec 7, 2005
Last updated
Sep 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 309000390 IL Primary

Addresses

Primary practice location

200 E 6TH St
Minonk, IL 61760-1308

Mailing address

301 S Bloomington St
Streator, IL 61364-2904
Phone (815) 673-2441

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
I20091202000586 IL Practitioner - Nurse Practitioner 2062551138 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309000390ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Podzamsky Medical Services Current Accepting new patients

Locations

120 E 7th St
Minonk, IL 61760
Phone (309) 432-2515

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

301 S Bloomington St
Streator, IL 61364
Phone (815) 673-2441

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1780669309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S BLOOMINGTON ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642904",
            "telephone_number": "815-673-2441",
            "fax_number": "815-672-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 6TH ST",
            "city": "MINONK",
            "state": "IL",
            "postal_code": "617601308",
            "telephone_number": "309-432-2441",
            "fax_number": "309-432-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "SHARON",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "309000390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minonk, IL

Sources for this page

Verify at the official NPI Registry.