Evan Walder

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

209031039 Issued in IL

Practice address

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Phone

(309) 672-5522

NPI assigned

Nov 16, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Methodist Medical Center of IllinoisGroup PAC ID 1355259714, shared by 8 NPIs, 387 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
• Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
• Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewalderrn321917@carlehiedirect.net

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Methodist Medical Center of Illinois

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  Care Compare affiliation
• Pekin Memorial Hospital

  • General Acute Care Hospital
  • Pekin, IL
  • NPI 1245227479
  Care Compare affiliation
• Proctor Community Hospital

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1033116876
  Care Compare affiliation
• Proctor Community Hospital

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1134826894
  Care Compare affiliation

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

{
    "created_epoch": "1731715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731715200000",
    "number": "1891510731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 BROOKLINE DR",
            "city": "EUREKA",
            "state": "IL",
            "postal_code": "615301600",
            "telephone_number": "330-749-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDER",
        "first_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-16",
        "last_updated": "2024-11-16",
        "certification_date": "2024-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209031039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Robert Wakid, M.D.
• Wal-Mart Stores, Inc
• Wal-Mart Stores, Inc
• Saqib Walayat, M.D.
• Taylor Dayne Walden, MS, CF-SLP
• Anne E Waldrop, PT
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co

• Acute Care Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Acute Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2024; 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.