Nancy K Kertz, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Practice address

4117 S Water Tower PL
Suite D
Mount Vernon, IL 62864-6293

Phone

(618) 242-4848

Fax

(618) 242-4198

NPI assigned

Aug 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Physician Services Corporation of Southern Illinois Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1063424836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 LINCOLN LN",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062634",
            "telephone_number": "605-695-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 S WATER TOWER PL",
            "address_2": "SUITE D",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646293",
            "telephone_number": "618-242-4848",
            "fax_number": "618-242-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERTZ",
        "first_name": "NANCY",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000435",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neeta B Kaushal, MD
• James Edward Keeler, PA-C
• Deanna Marie Keiser
• Rya Keller, SLP
• James Kellerman, M.H.P.
• Chelsea Danielle Kesel, MS, CCC-SLP
• Deborah M Kessler, OT
• Kirandeep Khangura, MBBS
• Justin Kim
• King City Physician Company, LLC

• Family Nurse Practitioner in Mount Vernon, IL
• Providers in Mount Vernon, 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 Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.