ETHAN SPERRY
NPI 1861371635
Nurse Practitioner - Family in Peoria, IL
About Ethan Sperry NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN SPERRY (NPI 1861371635) is an individual family provider in Peoria, Illinois, licensed in Illinois (209-033064) and active in the NPI registry since August 2025. He is enrolled in Medicare PECOS, is affiliated with Saint James Hospital, and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ethan Sperry 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Saint James Hospital
Acute Care Hospitals · Pontiac, ILPhysician 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.
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.
PEORIA, IL 61637
PEORIA, IL 61637
PEORIA, IL 61637
PEORIA, IL 61637
PEORIA, IL 61637
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 Ethan Sperry's NPI number?
The NPI number for Ethan Sperry is 1861371635. It was assigned to this individual provider in the NPPES registry on August 27, 2025.
Where is Ethan Sperry located?
Ethan Sperry practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-2000.
What is Ethan Sperry's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Ethan Sperry enrolled in Medicare?
Yes. Ethan Sperry is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Ethan Sperry affiliated with any hospitals?
According to CMS data, Ethan Sperry is affiliated with Saint James Hospital.
When was this NPI record last updated?
The NPPES record for Ethan Sperry was last updated on August 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Ethan Sperry · NPI 1861371635
Family physician in Peoria, Illinois. Individual provider, active in the CMS NPPES registry since August 27, 2025.
## Identity
- **NPI:** 1861371635 (Entity type: Individual)
- **Enumerated:** August 27, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 209-033064 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 530 NE GLEN OAK AVE, Peoria, IL 61637-0001
- **Phone:** (309) 655-2000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** August 27, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1861371635) · Data from the CMS NPPES public registry.