Active NPI
Stephanie S Krogull
- Nurse Practitioner
- Rockford, IL
National Provider Identifier
1073157996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209020365
- Practice address
- 363 Financial CT Unit 300
Rockford, IL 61107-6671 - Phone
- (815) 397-3691
- NPI assigned
- Nov 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209020365 | IL | Primary |
Addresses
Primary practice location
363 Financial CT Unit 300
Rockford, IL 61107-6671
Mailing address
4653 High Point Dr Apt 28
Rockford, IL 61114-4822
Phone (815) 601-4013
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1203 W Augusta Blvd
Chicago, IL 60642-4327
Phone (773) 248-2255
709 Meadow Park Dr
Clinton, WI 53525-9777
Phone (773) 248-2255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heartland Hospice Services, LLC | Past | Accepting new patients | |
| Heartland Hospice Services LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Community Based Hospice Care Agency
- Rockford, IL
- NPI 1578516290
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Beltsville, MD
- NPI 1902545270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572825600000",
"number": "1073157996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4653 HIGH POINT DR APT 28",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611144822",
"telephone_number": "815-601-4013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "363 FINANCIAL CT UNIT 300",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611076671",
"telephone_number": "815-397-3691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROGULL",
"first_name": "STEPHANIE",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-04",
"last_updated": "2019-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209020365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.