Kimberly A Kish, APN, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209009873 Issued in IL

Practice address

2880 N Monroe St
Decatur, IL 62526-3269

Phone

(217) 330-8939

Fax

(217) 330-9063

NPI assigned

Oct 9, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring V Home health agency, Springfield, IL, CCN 148086
• Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
• St Marys Hospital Hospital, Decatur, IL, CCN 140166

Merit-based Incentive Payment System (MIPS)

Final score

73.88 of 100Reported as group

Quality

63.91

Improvement activities

40

Cost

77.03

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberlykish@sfc.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725
  Medicare reassignment Care Compare group NPD
• Vitalskin Medical Group Il PLLC

  • Dermatology Physician
  • Mattoon, IL
  • NPI 1063030252
  Medicare reassignment NPD
• Decatur Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Decatur, IL
  • NPI 1477276301
  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1548357973
  Care Compare affiliation
• First Care Healthcare Inc.

  • Home Health Agency
  • Springfield, IL
  • NPI 1780823377
  Care Compare affiliation
• St Marys Hospital Decatur of the Hospital Sisters of the Third Order

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1326041229
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1023360419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 N MONROE ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263269",
            "telephone_number": "217-330-8939",
            "fax_number": "217-330-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 N MONROE ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263269",
            "telephone_number": "217-330-8939",
            "fax_number": "217-330-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISH",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "APN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkish@kmc.kirbymedicalcenter.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "407 S Jackson St Ste A",
            "city": "Cerro Gordo",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618184360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristin L King
• Rodney Kingston, MD
• Courtney Dyan Kirk
• Audria R Kirkum
• Jason Kish, CRNA
• Therese Kistenfeger, AU.D.
• Suzanne Michelle Kistner-Davis, D.C.
• Shannon Dawn Klaska, BCABA
• Susan M Klein, M.D.
• Jaclyn Nicole Kleman

• Family Nurse Practitioner in Decatur, IL
• Providers in Decatur, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.