MS. NICOLE MARIE HARRIS MSN, PMHNP-BC
NPI 1497341994
Nurse Practitioner - Psychiatric/Mental Health in Peoria, IL

Q: What is Nicole Harris's NPI number?

The NPI number for Nicole Harris is 1497341994. It was assigned to this individual provider in the NPPES registry on December 18, 2020.

Q: What is Nicole Harris's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Harris was last updated on July 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.

Active since December 18, 2020PECOS EnrolledAccepts Medicare Assignment

228 NE JEFFERSON AVE, PEORIA, IL 61603(309) 671-8000 Get Directions Write a Review

NPPES record last updated: July 27, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 13, 2022, Dec 30, 2020, Dec 18, 2020 (3 updates tracked since 2020).

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About Ms. Nicole Marie Harris Msn, Pmhnp-bc NPPES

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

MS. NICOLE MARIE HARRIS MSN, PMHNP-BC (NPI 1497341994) is an individual psychiatric/mental health provider in Peoria, Illinois, licensed in Illinois (209.021964) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1497341994

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMS. NICOLE MARIE HARRISCredential: MSN, PMHNP-BC

Location Address228 NE JEFFERSON AVEPeoria, IL 61603-3802

Mailing Address228 Ne Jefferson AvePeoria, IL 61603-3802 · (309) 671-8000

Phone(309) 671-8000

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateDecember 18, 2020

Last NPPES UpdateJuly 27, 20253 updates tracked since enumeration

NPPES CertifiedJuly 27, 2025

✔ NPI 1497341994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in IL · 209.021964

228 NE JEFFERSON AVE, Peoria, IL 61603

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Nicole Marie Harris Msn, Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123535127

PECOS Enrollment IDI20250725000255

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.

Medicare Billing Reassignments

Medicare enrollment records show Nicole Harris reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Human Service Center

Same address

Mental Health (Including Community Mental Health Center)

228 NE JEFFERSON
Peoria, IL 61603

Reassigned Medicare billing, Illinois enrollment
18 clinicians in this Medicare group

NPI 1881630689 (309) 671-8000

Tazwood Mental Health Center, Inc.

10 mi

Mental Health (Including Community Mental Health Center)

3248 VANDEVER AVE
Pekin, IL 61554

Reassigned Medicare billing, Illinois enrollment
18 clinicians in this Medicare group

NPI 1083671127 (309) 347-5522

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140067

Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61603 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 15

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

DR. GEORGE KENNETH SHOTICK JR. M.D.

Family Medicine