CENTRAL ILLINOIS FRIENDS OF PWA, INC.
NPI 1447866900
Clinic/Center - Community Health in Peoria, IL

NPI Status: Active since September 21, 2020

Contact Information

2112 E WAR MEMORIAL DR
PEORIA, IL
ZIP 61614
Phone: (309) 431-5880

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  • Organization
  • Clinic/Center
  • Community Health
  • CLIA Number: 14D2045437
  • CLIA Cert. Type: Other - AIDS SERVICE ORGANIZATION
  • CLIA Exp. Date: 08-12-2026

About CENTRAL ILLINOIS FRIENDS OF PWA, INC.

This page provides the complete NPI Profile along with additional information for Central Illinois Friends Of Pwa, Inc., a primary care provider established in Peoria, Illinois operating as a Clinic/center, focusing in community health . The healthcare provider is registered in the NPI registry with number 1447866900 assigned on September 2020. The practitioner's primary taxonomy code is 261QC1500X. The provider is registered as an organization and their NPI record was last updated January 2026. The authorized official of this NPI record is Deric Kimler (Executive Director)

NPI
1447866900
Provider Name
CENTRAL ILLINOIS FRIENDS OF PWA, INC.
Entity Type
Organization
Location Address
2112 E WAR MEMORIAL DR PEORIA, IL 61614
Location Phone
(309) 431-5880
Mailing Address
PO BOX 5022 PEORIA, IL 61601
Mailing Phone
(309) 671-2144
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-21-2020
Last Update Date
01-23-2026
Code Navigator

A primary care provider (PCP) like Central Illinois Friends Of Pwa, Inc. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Community Health

Taxonomy Code
261QC1500X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1251B00000XAgencies

Case Management

 
2251K00000XAgencies

Public Health or Welfare

 
3251S00000XAgencies

Community/Behavioral Health

 
4251V00000XAgencies

Voluntary or Charitable

 
5363LC1500XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Community Health

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DERIC KIMLER

Authorized Official Title
EXECUTIVE DIRECTOR
Authorized Official Phone
(309) 671-2144

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2045437
Facility Type
Other - AIDS SERVICE ORGANIZATION
Certificate Effective Date
August 13, 2024
Certificate Expiration Date
August 12, 2026
Laboratory Director
ADAM HOUGHTON M D
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Central Illinois Friends Of Pwa, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1447866900, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
4
Doubled → 8
Pos 4
7
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
6
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
9
Unchanged
Pos 9
0
Doubled → 0
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 8 → 16 → 7 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 8 + 7 + 1 + 6 + 6 + 1 + 2 + 9 + 0 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1447866900.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Nurse Practitioner (Community Health)
2112 E WAR MEMORIAL DR
PEORIA, IL 61614

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1447866900, enumerated as an "organization" on September 21, 2020.

The provider is located at 2112 E WAR MEMORIAL DR PEORIA, IL 61614 and the phone number is (309) 431-5880.

Clinic/Center with taxonomy code 261QC1500X and a focus in Community Health.