Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samantha Martin, AGACNP-BC

Individual provider Gerontology Nurse Practitioner · NPI 1396314308

Samantha Martin, AGACNP-BC is a Nurse Practitioner in Peoria, Illinois. Qualified in 2020, 6 years ago. Practices with The Board of Trustees of the University of Illinois, a 1,142-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
6
Licensed in
IL
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

Address: 530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 209022870 (IL)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 209022870 (IL)

Record details

NPI number1396314308
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedJune 23, 2021
Last updated in NPPESJune 23, 2021
Certification dateJune 23, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice The Board Of Trustees Of The University Of Illinois — 1142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Peoria