Individual provider Active NPI

Jamie Schupbach, NP

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1932554714
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209014135 Issued in IL
Practice address
900 Main St
Ste 600
Peoria, IL 61602-1005
Phone
(309) 671-8270
Fax
(309) 672-3171
NPI assigned
Apr 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209014135 IL Primary

Addresses

Primary practice location

900 Main St
Ste 600
Peoria, IL 61602-1005

Mailing address

900 Main St
Ste 600
Peoria, IL 61602-1005
Phone (309) 671-8270

Other names 1

  • Jamie Guzman 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
I20160831000360 IL Practitioner - Nurse Practitioner 7012203045 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Home Physicians LLCGroup PAC ID 4981988771, 81 clinicians
Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians

Practice addresses (Care Compare)

1 S450 Summit Ave
Suite 165
Oakbrook Terrace, IL 60181-3952
Phone (630) 320-6871

300 Tenney St
Kewanee, IL 61443-3452
Phone (309) 853-5500

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209014135ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
In Home Medical Group LLC Family CurrentSince Jun 4, 2018 Accepting new patients
Proctor Health Systems CurrentSince Aug 23, 2016 Accepting new patients
Community Home Physicians, LLC CurrentSince Jan 15, 2025 Accepting new patients
Proctor Health Systems CurrentSince Aug 23, 2016 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 23, 2016 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Proctor Health Systems Current Accepting new patients
Transitions Home Medical Group PLLC CurrentSince Jun 15, 2021 Accepting new patients
Methodist Medical Center of Illinois Family CurrentSince Aug 23, 2016 Accepting new patients
The SNF Group, PLLC Past Accepting new patients

Locations

1506 W Garfield Ave
Bartonville, IL 61607
Phone (309) 697-2416

2312 Touhy Ave
Elk Grove Vlg, IL 60007
Phone (816) 637-2200

1S450 Summit Ave
Ste 270
Oakbrook Terrace, IL 60181

1S450 Summit Ave
Ste 165
Oakbrook Terrace, IL 60181
Phone (630) 320-6871

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

900 Main St
Ste 600
Peoria, IL 61602
Phone (309) 671-3170

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

815 Main St
Ste A1
Peoria, IL 61602

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

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

4215 Newburg Rd
Rockford, IL 61108
Phone (815) 988-8500

2222 E State St
Ste 209
Rockford, IL 61104
Phone (815) 988-8500

Organizations & group practices 10

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1932554714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "address_2": "STE 600",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021005",
            "telephone_number": "309-671-8270",
            "fax_number": "309-672-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "address_2": "STE 600",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021005",
            "telephone_number": "309-671-8270",
            "fax_number": "309-672-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPBACH",
        "first_name": "JAMIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "GUZMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.