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MRS. SHANNON MARIE ROBERTS APRN
NPI 1215533245
Nurse Practitioner - Family in Peoria, IL

Active since December 06, 2020PECOS Enrolled
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2000 Get Directions Write a Review

NPPES record last updated: December 7, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 7, 2020, Dec 6, 2020 (2 updates tracked since 2020).

About Mrs. Shannon Marie Roberts Aprn NPPES

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

MRS. SHANNON MARIE ROBERTS APRN (NPI 1215533245) is an individual family provider in Peoria, Illinois, licensed in Illinois (209021936) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215533245
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. SHANNON MARIE ROBERTSCredential: APRN
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address10203 W Guinivere DrMapleton, IL 61547-9586 · (309) 241-7178
Phone(309) 655-2000
Sole ProprietorYes
Enumeration DateDecember 6, 2020
Last NPPES UpdateDecember 7, 20202 updates tracked since enumeration
NPPES CertifiedDecember 7, 2020
✔ NPI 1215533245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209021936
530 NE GLEN OAK AVE, Peoria, IL 61637
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Shannon Marie Roberts Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEEPAK S NAIR M.D.
Psychiatry & Neurology (Neurology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ERIC TYLER AMPARAN MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2274
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109

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 Shannon Roberts's NPI number?

The NPI number for Shannon Roberts is 1215533245. It was assigned to this individual provider in the NPPES registry on December 6, 2020.

Where is Shannon Roberts located?

Shannon Roberts practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-2000.

What is Shannon Roberts's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shannon Roberts enrolled in Medicare?

Yes. Shannon Roberts is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Roberts was last updated on December 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.