Individual provider Active NPI

Cheryl Marie Lucas McCoy, APRN, CNP

  • Family Nurse Practitioner
  • Ottawa, IL
National Provider Identifier
1811643315
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024769 Issued in IL
Practice address
1100 E Norris Dr
Ottawa, IL 61350-1604
Phone
(815) 433-3100
Fax
(815) 433-0879
NPI assigned
Feb 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.024769 IL
Family Nurse Practitioner 363LF0000X 209024769 IL Primary

Addresses

Primary practice location

1100 E Norris Dr
Ottawa, IL 61350-1604

Mailing address

1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100

Other practice location 1

3101 7th St
Peru, IL 61354-2471
Phone (815) 343-3377

Other names 1

  • Cheryl Marie Lucas Former name

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
I20230926000638 IL Practitioner - Nurse Practitioner 5991159923 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
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)

1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.024769ILMDNurse Practitioner
209024769ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mendota Community Hospital Nurse Practitioner Current Accepting new patients
Mendota Community Hospital CurrentSince Dec 17, 2024 Accepting new patients
Saint James Hospital CurrentSince Dec 17, 2024 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Dec 17, 2024 Accepting new patients
Osf Healthcare System CurrentSince Dec 17, 2024 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Dec 17, 2024 Accepting new patients
Osf Healthcare System CurrentSince Dec 17, 2024 Accepting new patients
Saint James Hospital CurrentSince Dec 17, 2024 Accepting new patients
Mendota Community Hospital CurrentSince Dec 17, 2024 Accepting new patients

Locations

1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825

1401 E 12th St
Mendota, IL 61342
Phone (815) 539-7461

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

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

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

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

Organizations & group practices 11

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 1

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": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1811643315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501604",
            "telephone_number": "815-433-3100",
            "fax_number": "815-433-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501604",
            "telephone_number": "815-433-3100",
            "fax_number": "815-433-0879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 7th St",
            "address_purpose": "LOCATION",
            "city": "Peru",
            "state": "IL",
            "postal_code": "613542471",
            "country_code": "US",
            "telephone_number": "815-343-3377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS MCCOY",
        "first_name": "CHERYL",
        "middle_name": "MARIE",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.024769",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "LUCAS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ottawa, IL

Sources for this page

Verify at the official NPI Registry.