LISA NANNIE FNP
NPI 1417962937
Nurse Practitioner - Family in Peoria, IL

Q: What is the provider's specialty?

The provider's specialty is Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

Active since July 31, 2006PECOS Enrolled

8914 N KNOXVILLE AVE, PEORIA, IL 61615(309) 691-9110 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Lisa Nannie Fnp NPPES

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

LISA NANNIE FNP (NPI 1417962937) is an individual family provider in Peoria, Illinois, licensed in Illinois (209001338) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417962937

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLISA NANNIECredential: FNP

Location Address8914 N KNOXVILLE AVEPeoria, IL 61615-1410

Mailing Address5100 Reliable PkwyChicago, IL 60686-0001 · (309) 672-4809

Phone(309) 691-9110

Sole ProprietorNo

Enumeration DateJuly 31, 2006

Last NPPES UpdateOctober 12, 2023

NPPES CertifiedOctober 12, 2023

✔ NPI 1417962937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209001338

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 209001338 (IL)

8914 N KNOXVILLE AVE, Peoria, IL 61615

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Other Identifiers 4

Other050884IL · Health Alliance

OtherIL01W1IL · John Deere

Other472307IL · Healthlink

Other7215059IL · Bcbs Ppo

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Nannie Fnp 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 61615 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 14

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

JESSICA HIGGS MD

Family Medicine