Individual provider Active NPI

Julian Paul Taylor

  • Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1841889037
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209020977 Issued in IL
Practice address
10408 N Centerway Dr
Peoria, IL 61615-1234
Phone
(309) 308-5100
NPI assigned
Jan 13, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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 209020977 IL Primary

Addresses

Primary practice location

10408 N Centerway Dr
Peoria, IL 61615-1234

Mailing address

10408 N Centerway Dr Ste Cde
Peoria, IL 61615-1234
Phone (309) 308-5100

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
I20210305001775 IL Practitioner - Nurse Practitioner 0042626665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
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)

5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone (309) 683-8156

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

8800 State Route 91
Peoria, IL 61615-9473
Phone (309) 683-5000

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Mar 15, 2021 Accepting new patients
Osf Multi-Specialty Group PastSince Apr 20, 2021 Accepting new patients

Locations

435 Maxine Dr
Morton, IL 61550
Phone (309) 263-2424

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

8800 State Route 91
Peoria, IL 61615
Phone (309) 683-5000

10408 N Centerway Dr
Ste Cde
Peoria, IL 61615

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

5114 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 655-2431

10408 N Centerway Dr
Peoria, IL 61615

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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1841889037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10408 N CENTERWAY DR STE CDE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151234",
            "telephone_number": "309-308-5100",
            "fax_number": "309-308-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10408 N CENTERWAY DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151234",
            "telephone_number": "309-308-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JULIAN",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209020977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.