Individual provider Active NPI

Jennifer Lynn Soady, DNP, APRN, CNM

  • Advanced Practice Midwife
  • Peoria, IL
National Provider Identifier
1801509443
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
2419 W Cornerstone CT
Peoria, IL 61614-2529
Phone
(217) 528-7541
NPI assigned
Dec 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X Primary

Addresses

Primary practice location

2419 W Cornerstone CT
Peoria, IL 61614-2529

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Other practice location 1

617 Illini Dr.
East Peoria, IL 61611
Phone (309) 267-4457

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230922002724 IL Practitioner - Certified Nurse Midwife (CNM) 8022462126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2500 W Reynolds St
Pontiac, IL 61764-9774

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Sep 11, 2023 Accepting new patients
Springfield Clinic, LLP CurrentSince Feb 12, 2024 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

2111 E Oakland Ave
Ste B
Bloomington, IL 61701
Phone (309) 531-3012

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

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

2419 W Cornerstone Ct
Peoria, IL 61614
Phone (309) 265-3415

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

920 West St
Ste 100
Peru, IL 61354
Phone (815) 431-0435

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

Interoperability endpoints

  • Direct secure messaging: jennifer.soady.1@28977.direct.athenahealth.com

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": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1801509443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 W CORNERSTONE CT",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142529",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 Illini Dr.",
            "address_purpose": "LOCATION",
            "city": "East Peoria",
            "state": "IL",
            "postal_code": "61611",
            "country_code": "US",
            "telephone_number": "309-267-4457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOADY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "DNP, APRN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-28",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.