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CENTRAL ILLINOIS CENTER FOR WELLNESS, LLC
NPI 1104391739
Clinic/Center - Primary Care in Bloomington, IL

Active since October 10, 2018
2501 E COLLEGE AVE STE C, BLOOMINGTON, IL 61704(309) 807-5356(309) 807-5291 Get Directions Write a Review

NPPES record last updated: August 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 1, 2024, Oct 10, 2018 (2 updates tracked since 2018).

About Central Illinois Center For Wellness, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTRAL ILLINOIS CENTER FOR WELLNESS, LLC (NPI 1104391739) is a healthcare organization registered as a primary care in Bloomington, Illinois and active in the NPI registry since October 2018. The organization lists William John Ray, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1104391739
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCENTRAL ILLINOIS CENTER FOR WELLNESS, LLC
Location Address2501 E COLLEGE AVE STE CBloomington, IL 61704-2484
Mailing Address2501 E College Ave Ste CBloomington, IL 61704-2484 · (309) 807-5356 · Fax (309) 807-5291
Phone(309) 807-5356
Fax(309) 807-5291
Organization SubpartNo
Authorized OfficialWilliam John RayPhysician/owner · (309) 807-5356
Enumeration DateOctober 10, 2018
Last NPPES UpdateAugust 1, 20242 updates tracked since enumeration
NPPES CertifiedAugust 1, 2024
✔ NPI 1104391739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
2501 E COLLEGE AVE STE C, Bloomington, IL 61704
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Central Illinois Center For Wellness, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Central Illinois Center For Wellness, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

William Ray, M.D.
Internal Medicine
NPI 1689672859
2501 E COLLEGE AVE STE C
Bloomington, IL 61704
(309) 807-5356
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2155696

Central Illinois Center For Wellness · Bloomington, IL
Expired · Oct 2, 2026
CLIA Number14D2155696
Laboratory TypePhysician Office
Certificate Effective DateOctober 3, 2024
Certificate Expiration DateOctober 2, 2026
Laboratory DirectorWilliam J. Ray
Laboratory Phone(309) 807-5356
Laboratory LocationCentral Illinois Center For Wellness2501 E College Ave - Ste C, Bloomington, IL 61704
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Central Illinois Center For Wellness, LLC's NPI number?

The NPI number for Central Illinois Center For Wellness, LLC is 1104391739. It was assigned to this organization in the NPPES registry on October 10, 2018.

Where is Central Illinois Center For Wellness, LLC located?

Central Illinois Center For Wellness, LLC is located at 2501 E College Ave Ste C, Bloomington, IL 61704. The listed phone number is (309) 807-5356.

What is Central Illinois Center For Wellness, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Central Illinois Center For Wellness, LLC enrolled in Medicare?

Yes. Central Illinois Center For Wellness, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Central Illinois Center For Wellness, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Central Illinois Center For Wellness, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Central Illinois Center For Wellness, LLC accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Central Illinois Center For Wellness, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Central Illinois Center For Wellness, LLC was last updated on August 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.