Individual provider Active NPI

Casey David Williams, FNP

  • Primary Care Nurse Practitioner
  • Roanoke, IL
National Provider Identifier
1992670053
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
209.033457 Issued in IL
Practice address
401 N Main St
Roanoke, IL 61561-7585
Phone
(309) 923-2661
NPI assigned
Oct 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 209.033457 IL Primary

Addresses

Primary practice location

401 N Main St
Roanoke, IL 61561-7585

Mailing address

401 N Main St
Roanoke, IL 61561-7585
Phone (815) 482-7458

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
I20251027003743 IL Practitioner - Nurse Practitioner 6103315502 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint James Hospital 74 clinicians
Osf Multi-Specialty Group 2,123 clinicians

Practice addresses (Care Compare)

2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828

401 N Main St
Osf Healthcare Medical Group Roanoke
Roanoke, IL 61561-7585
Phone (309) 923-2661

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

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.033457ILMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint James Hospital CurrentSince Oct 1, 2025 Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 1, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Saint James Hospital CurrentSince Oct 1, 2025 Accepting new patients
Saint James Hospital Past Accepting new patients

Locations

3422 Court St
#A
Pekin, IL 61554
Phone (309) 477-6000

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

5114 N Glen Park Place Rd
Ste 110
Peoria, IL 61614
Phone (309) 683-5600

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

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1759881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1992670053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "ROANOKE",
            "state": "IL",
            "postal_code": "615617585",
            "telephone_number": "815-482-7458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "ROANOKE",
            "state": "IL",
            "postal_code": "615617585",
            "telephone_number": "309-923-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CASEY",
        "middle_name": "DAVID",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-08",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209.033457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, IL

Sources for this page

Verify at the official NPI Registry.