Individual provider Active NPI

Katherine A Chesnut, AUD

  • Audiologist
  • Mattoon, IL
National Provider Identifier
1053965806
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147001718 Issued in IL
Practice address
1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653
Phone
(217) 258-2409
Fax
(217) 258-2323
NPI assigned
Jul 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147001718 IL Primary

Addresses

Primary practice location

1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653

Mailing address

PO Box 372
Mattoon, IL 61938-0372

Other practice location 1

3105 Fields South Dr
Champaign, IL 61822-3743
Phone (217) 902-3277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190918000525 IL Practitioner - Qualified Audiologist 5395075329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince Jun 22, 2025 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jun 22, 2025 Accepting new patients

Locations

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1053965806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DR STE 201",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384653",
            "telephone_number": "217-258-2409",
            "fax_number": "217-258-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3105 Fields South Dr",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618223743",
            "country_code": "US",
            "telephone_number": "217-902-3277",
            "fax_number": "217-902-7757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHESNUT",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147001718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.