SANDRA L. PEACH (APN) – Nurse Practitioner, NPI 1003268897

SANDRA L. PEACH (APN) is a healthcare provider. based in Peoria, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APN. They hold a License No. 209014408 (IL). The NPI Number for SANDRA L. PEACH (APN) is 1003268897

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
SANDRA L. PEACH (APN)
NPI
1003268897
Phone
(309) 655-2343
Address
420 NE GLEN OAK AVE
Enumeration Date
6 July 2016
Last Update Date
21 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3093085100
Graduation Year
2016 (10 years ago)
PAC ID
2466746805
Group Practice PAC ID
3678889789
Professional Enrollment ID
I20160809000613
Address ID
IL616041401PE3626XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness85
Years active:9State licenses:2Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

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Provider Addresses for SANDRA L. PEACH (APN)

  • 420, Northeast Glen Oak Avenue, Peoria, Peoria County, Illinois, 61603, United States

    PEORIA, IL 616033105

    Phone: (309) 655-2343

    Fax: (309) 655-3948

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 58 Open Payments records for all available years, with a total value of $1,083.

Total Amount is formed as General ($1,083) + Research ($0) + Ownership ($0) = $1,083.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($221).

Total Amount

$1,083

General + Research + Ownership

Payments

58

Total payment records

General Amount

$1,083

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-08-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160809000613INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61603)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678889789View full group profile

Reviews

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Frequently asked questions

Does SANDRA L. PEACH (APN) have a public NPI I can cite?
Public records show SANDRA L. PEACH (APN) under NPI 1003268897.
Is SANDRA L. PEACH (APN) currently accepting referrals based on NPI status?
Registry metadata lists SANDRA L. PEACH (APN) as active.
How should patients interpret SANDRA L. PEACH (APN)'s specialty?
The extract shows Nurse Practitioner for SANDRA L. PEACH (APN). Clinical services aligned with this taxonomy classification.
What city is tied to SANDRA L. PEACH (APN)?
The directory associates SANDRA L. PEACH (APN) with Peoria, Illinois. Check all listed addresses for suites or satellite offices.
Why is information missing for SANDRA L. PEACH (APN)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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