TONYA MOORE (NPI# 1225434772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225434772 |
| Entity Type | Individual |
| Full Name | TONYA MOORE |
| Credential | APN |
| Practice Address |
420 Ne Glen Oak Ave Ste 401 Peoria IL 61603-3168 |
| Mailing Address |
420 Ne Glen Oak Ave Ste 401 Peoria IL 61603-3168 |
| Practice Telephone | 3096768123 |
| Practice Fax Number | 3096768455 |
| Mailing Telephone | 3096768123 |
| Mailing Fax Number | 3096768455 |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2018-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 41376288 | IL | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209012046 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 209012046 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295107746 | Tonya Moore | Marriage & Family Therapist | 930 175th St Ste 2ne-b, Homewood, IL 60430-2039 | 2015-10-23 |
| 1841606993 | Tonya Moore | Home Health Aide | 57 Freda Jane Ln, Birmingham, AL 35215-7064 | 2014-07-09 |
| 1174031272 | Tonya R Moore | Nurse Practitioner | 5151 N 9th Ave, Pensacola, FL 32504-8721 | 2018-01-11 |
| 1043545577 | Tonya Michelle Moore | Counselor | 1001 S Marshall St, Suite 1-11, Winston Salem, NC 27101-5852 | 2009-10-16 |
| Street Address |
420 NE GLEN OAK AVE STE 401 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710974597 | Timothy P Oconnor | Transplant Surgery | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603 | 2005-10-05 |
| 1962994707 | Michelle Sue Dehne | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2018-06-06 |
| 1780060517 | Danae Smith | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2015-08-04 |
| 1568848497 | Sarah Adams | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2015-08-03 |
| 1497172399 | Jill Oberle | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2014-03-28 |
| 1629344064 | David Edward Houser | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2012-03-29 |
| 1538325477 | Raji Jacob | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2008-07-30 |
| 1669648309 | Muhammad Waqar Khattak | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603 | 2008-05-02 |
| 1982816237 | Anu Vishwanath | Pediatrics | 420 Ne Glen Oak Ave Ste 401, Suite 401, Peoria, IL 61603-3168 | 2007-05-07 |
| 1124152707 | Alexander J. Alonso | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2007-03-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1699390039 | Steven Joel Schlink | Nurse Practitioner | 12920 W Roy Rogers Rd, Peoria, AZ 85383-5334 | 2020-06-11 |
| 1457986929 | Chanelle Christine Maclin | Nurse Practitioner | 504 E Kansas St, Peoria, IL 61603-2554 | 2020-03-05 |
| 1225677495 | Michelle Chacon | Nurse Practitioner | 23201 N 87th Dr, Peoria, AZ 85383-1860 | 2020-01-05 |
| 1689218042 | Patricia Nwakaego Ayemoba | Nurse Practitioner | 16018 N 74th Dr, Peoria, AZ 85382-1810 | 2019-10-29 |
| 1144877267 | Eunice Wright | Nurse Practitioner | 26826 N 85th Dr, Peoria, AZ 85383-3624 | 2019-08-22 |
| 1861057507 | Shawnee Renee Fudurich | Nurse Practitioner | 10230 W Happy Valley Pkwy Ste 100, Peoria, AZ 85383-4255 | 2019-05-08 |
| 1265096895 | Razel Espiritu Hernandez | Nurse Practitioner | 25435 N 115th Ave, Peoria, AZ 85383-9789 | 2019-04-29 |
| 1619435310 | Jennifer Gayle Ries-clark | Nurse Practitioner | 8009 W Salter Dr, Peoria, AZ 85382-4440 | 2019-03-12 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.