Alexis Renee Priddy

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036172706 Issued in IL

Practice address

5114 N Glen Park Place Rd Ste 110
Peoria, IL 61614-4686

Phone

(309) 683-5600

Fax

(309) 683-5607

NPI assigned

Apr 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

Other, 2021

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)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1881274785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 N GLEN PARK PLACE RD STE 110",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144686",
            "telephone_number": "309-683-5600",
            "fax_number": "309-683-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 N GLEN PARK PLACE RD STE 110",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144686",
            "telephone_number": "309-683-5600",
            "fax_number": "309-683-5607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 First Street",
            "address_2": "MSC#83",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "31201",
            "country_code": "US",
            "telephone_number": "478-633-1851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Hemlock St",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312012102",
            "country_code": "US",
            "telephone_number": "478-633-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIDDY",
        "first_name": "ALEXIS",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036172706",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "13452",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036172706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arpr225@uky.edu",
            "affiliation": "Y",
            "endpointDescription": "email address",
            "affiliationName": "University of Kentucky College of Medicine",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "800 Rose Street Mn 150",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405060001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arpr225@uky.edu",
            "affiliation": "Y",
            "endpointDescription": "email address",
            "affiliationName": "University of Kentucky College of Medicine",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "800 Rose Street Mn 150",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405060001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arpr225@uky.edu",
            "affiliation": "Y",
            "endpointDescription": "email address",
            "affiliationName": "University of Kentucky College of Medicine",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "800 Rose Street Mn 150",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405060001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caitlin Marie Pribble
• Derek P Price, PT
• Sarah Elizabeth Price, APN
• Tabitha C Price, PTA
• Todd Richard Price, PTA
• Jantzen Michelle Pride, MD
• James G. Priepot, M.D.
• Prime Care Services LLC
• Mandie Geneil Prior, DO
• Jacob Ryan Pritchard, LCPC

• Internal Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.