NPIMap

Individual provider Active NPI

Kayla Lorraine Kimmel, FNP

  • Family Nurse Practitioner
  • Benton, IL
National Provider Identifier
1063810463
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209012306 Issued in IL
Practice address
201 Bailey LN
Benton, IL 62812-1969
Phone
(618) 218-3690
NPI assigned
Dec 17, 2014
Last updated
Dec 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2014

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 209012306 IL Primary

Addresses

Primary practice location

201 Bailey LN
Benton, IL 62812-1969

Mailing address

802 N 9TH St
Apt B
Benton, IL 62812-2935
Phone (618) 218-3690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150528002750 IL Practitioner - Nurse Practitioner 5193045326 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Franklin Hospital DistrictGroup PAC ID 4082516042, shared by 5 NPIs, 32 clinicians

Practice addresses (Care Compare)

1104 W Main St
Benton, IL 62812-1565
Phone (618) 439-3399

201 Bailey LN
Benton, IL 62812-1969
Phone 6184393161332

326 E Main St
West Frankfort, IL 62896-2402
Phone (618) 937-6200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Hospital District CurrentSince Jan 5, 2015 Accepting new patients
Franklin Hospital District Family CurrentSince Jan 5, 2015 Accepting new patients
Franklin Hospital District Current Accepting new patients
Franklin Hospital District Past Accepting new patients

Locations

201 Bailey Ln
Benton, IL 62812
Phone (618) 438-3113

201 Bailey Ln
Fl 3
Benton, IL 62812
Phone (618) 435-9760

309 W Saint Louis St
West Frankfort, IL 62896
Phone (618) 937-2416

Interoperability endpoints

  • FHIR API: https://fhir.yourcareuniverse.net/tenant/c680de42-53d4-410c-a755-e5a226565d34
  • Direct secure messaging: kaylakimmel@franklinhhc.allscriptsdirect.net
  • Direct secure messaging: kkimmel@yourcarecommunity.org

Organizations & group practices 4

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 6

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": "1418774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1063810463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 N 9TH ST",
            "address_2": "APT B",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628122935",
            "telephone_number": "618-218-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BAILEY LN",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121969",
            "telephone_number": "618-218-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "KAYLA",
        "middle_name": "LORRAINE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-17",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, IL

Sources for this page

Verify at the official NPI Registry.