Individual provider Active NPI

Jeanna M Ross, APN

  • Adult Health Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1922061043
Registry record updated Feb 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209005204 Issued in IL
Practice address
2338 W Van Winkle Way Ste 3300
Peoria, IL 61615-7485
Phone
(309) 693-2020
NPI assigned
Apr 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209005204 IL Primary

Addresses

Primary practice location

2338 W Van Winkle Way Ste 3300
Peoria, IL 61615-7485

Mailing address

2338 W Van Winkle Way Ste 3300
Peoria, IL 61615-7485
Phone (309) 693-2020

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
I20060103000367 IL Practitioner - Nurse Practitioner 3577585678 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

2338 W Van Winkle Way
3300 Family Medicine North
Peoria, IL 61615-7485
Phone (309) 693-2020

5401 N Knoxville Ave
Peoria, IL 61614-5021

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209005204ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Jan 1, 2026 Accepting new patients
Proctor Health Systems Current Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Proctor Health Systems CurrentSince Mar 1, 2023 Accepting new patients
Pekin Prohealth Inc Past Accepting new patients

Locations

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A1
Peoria, IL 61602

2338 W Van Winkle Way
Ste 3300
Peoria, IL 61615
Phone (309) 693-2020

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

5401 N Knoxville Ave
Ste 207
Peoria, IL 61614
Phone (309) 672-4640

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 6

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 4

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738454400000",
    "number": "1922061043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 W VAN WINKLE WAY STE 3300",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157485",
            "telephone_number": "309-693-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 W VAN WINKLE WAY STE 3300",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157485",
            "telephone_number": "309-693-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JEANNA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2025-02-02",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209005204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.