Kaitlin Delaney Henry, M.D.
Individual provider Active NPI Family Medicine Physician · Springfield, IL
NPI 1003136276 · NPPES record last updated May 22, 2020
Key facts
- NPI
- 1003136276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036133961 (IL)
- Practice address
- 2200 Wabash Ave
Springfield, IL 62704 - Phone
- (217) 528-7541
- NPI assigned
- Jun 10, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 3
Owned or controlled facilities with NPI records 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Southern Illinois University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Springfield Clinic, LLP
Practice addresses (Care Compare)
2200 Wabash Ave
Springfield, IL 62704-5352
Phone (217) 787-0727
Hospital & facility affiliations
- Hospice Care of Illinois
- Memorial Medical Center
- St Johns Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.83 of 100
- Quality
- 75.65
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Springfield Clinic Lincoln Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2021 |
| Springfield Clinic Nokomis Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2023 |
| Springfield Clinic Raymond Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2021 |
| Springfield Clinic Neoga Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2021 |
| Springfield Clinic, LLP |
Rural health clinic | Limited Partnership Interest | Jan 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131107000764 | IL | Practitioner - Family Practice | 4284869868 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036133961 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Clinic, LLP | Current |
Accepting new patients |
Locations
1025 S 6th St
Springfield, IL 62703
775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300
2200 Wabash Ave
Springfield, IL 62704
Interoperability endpoints
- kaitlin.henry.1@28977.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036133961 | IL | Yes |
Addresses
Primary practice location
2200 Wabash Ave
Springfield, IL 62704
Mailing address
1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036133961 | Other | IL | IDFPR |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kaitlinhenry@sfc.allscriptsdirect.net |
Other providers in Springfield, IL
- Sarah H Hennemann
- Andrew Gene Henry
- Barbara Jane Henry
- Jillian Henry
- Justin Neil Henry
- Kelley Henry
- Amanda B Henson
- David Henson
- Jieun Heo
- Here an There Acessable Transport, Inc
All providers in Springfield, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.