Individual provider Active NPI

Kari N. Bruening, NP

  • Family Nurse Practitioner
  • Galesburg, IL
National Provider Identifier
1063675445
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
041340631 Issued in IL
Practice address
3375 N Seminary St
Galesburg, IL 61401-1251
Phone
(309) 343-5114
Fax
(309) 343-7859
NPI assigned
Jul 7, 2008
Last updated
Nov 3, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 041340631 IL Primary

Addresses

Primary practice location

3375 N Seminary St
Galesburg, IL 61401-1251

Mailing address

3375 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 343-5114

Other identifiers 3

IdentifierTypeStateIssuer
833610OtherILMEDICARE GROUP PTAN
CB6569OtherILRR MEDICARE GROUP PTAN
P00625331OtherILRR MEDICARE MEMBER PTAN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080912000343 IL Practitioner - Nurse Practitioner 3375619570

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Mary Medical CenterGroup PAC ID 8628038015, 52 clinicians
Graham Hospital AssociationGroup PAC ID 2769375021, shared by 15 NPIs, 124 clinicians

Practice addresses (Care Compare)

104 S Broadway St
Knoxville, IL 61448
Phone (309) 289-2335

1630 E Jackson St
Macomb, IL 61455-2530
Phone (309) 647-0201

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

2028 N Seminary St
Galesburg, IL 61401-4559
Phone (309) 647-0201

834 N Seminary
Suite 401 Osf Healthcare Medical Group Ga
Galesburg, IL 61401-0500
Phone (309) 446-3305

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041340631ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Healthcare System CurrentSince Jan 13, 2022 Accepting new patients
Osf Healthcare System CurrentSince Jan 13, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
St Mary Medical Center Current Accepting new patients
St Mary Medical Center Past Accepting new patients

Locations

1707 N Henderson St
Galesburg, IL 61401
Phone (309) 343-1000

3315 N Seminary St
Galesburg, IL 61401
Phone (309) 344-1000

3375 N Seminary St
Galesburg, IL 61401
Phone (309) 343-5114

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

535 Park Ave E
Princeton, IL 61356
Phone (815) 875-4531

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1063675445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-343-5114",
            "fax_number": "309-343-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-343-5114",
            "fax_number": "309-343-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUENING",
        "first_name": "KARI",
        "middle_name": "N.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041340631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "833610",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP PTAN",
            "identifier": "CB6569",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE MEMBER PTAN",
            "identifier": "P00625331",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.