Kim A Earl, APRN, PMHNP, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209007155 Issued in IL

Practice address

1124 S 6TH St
Springfield, IL 62703-2406

Phone

(217) 523-3143

Fax

(217) 523-1513

NPI assigned

Aug 27, 2008

Last updated

May 18, 2020By the provider in NPPES

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

Other names 1

• Kimberly A Earl Other name

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological Associates of Central Illinois LTDGroup PAC ID 1355318825, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Psychological Associates of Central Illinois LTD

  • Psychiatry Physician
  • Springfield, IL
  • NPI 1376698050
  Medicare reassignment Care Compare group NPD
• Memorial Medical Center

  dba The Hearing Center at Memorial

  • Audiologist
  • Springfield, IL
  • NPI 1679549968
  NPD (past)
• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  NPD (past)

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1063669497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032406",
            "telephone_number": "217-523-3143",
            "fax_number": "217-523-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032406",
            "telephone_number": "217-523-3143",
            "fax_number": "217-523-1513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Lake Victoria Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627035596",
            "country_code": "US",
            "telephone_number": "217-529-9266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EARL",
        "first_name": "KIM",
        "middle_name": "A",
        "credential": "APRN, PMHNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209007155",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209007155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "EARL",
            "middle_name": "A",
            "credential": "APRN, PMHNP, FNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Michal Dynda, MD
• Sandra K Eades, LCPC
• Lanie E Eagleton, M.D.
• Linda J Eagleton
• Kelsi Earl, APN
• Joshua Kieth Eaves, LCSW
• Eberhardt Chiropractic Inc
• Aura M Eberhardt, M.D.
• Don F Eberhardt, DC
• Kristen Eckhart, CRNA

• Psychiatric/Mental Health Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.