NPIMap

Individual provider Active NPI

Kerry Woss, D.O.

  • Family Medicine Physician
  • Clarendon Hills, IL
National Provider Identifier
1073968418
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036149704 Issued in IL
Practice address
99 Park Ave Ste 102
Clarendon Hills, IL 60514-1494
Phone
(630) 455-7000
NPI assigned
May 3, 2016
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036149704 IL Primary

Addresses

Primary practice location

99 Park Ave Ste 102
Clarendon Hills, IL 60514-1494

Mailing address

99 Park Ave Ste 102
Clarendon Hills, IL 60514-1494
Phone (630) 455-7000

Other names 1

  • Kerry Matney Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kerry.woss.1@380.direct.athenahealth.com

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
I20190926000071 IL Practitioner - Family Practice 0547550964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Osteopathy, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventist Health Partners, Inc.Group PAC ID 0244135762, 253 clinicians

Practice addresses (Care Compare)

396 Remington Blvd
Bolingbrook, IL 60440-4311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036149704ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Partners,Inc Family Medicine CurrentSince Oct 1, 2019 Accepting new patients
Adventist Health Partners, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Adventist Health Partners, Inc. Current Accepting new patients
Adventist Health Partners,Inc Family Medicine Past Accepting new patients

Locations

396 Remington Blvd
Ste 231
Bolingbrook, IL 60440
Phone (630) 312-4301

99 Park Ave
Ste 102
Clarendon Hls, IL 60514
Phone (630) 308-2460

Interoperability endpoints

  • Direct secure messaging: kerry.woss.1@380.direct.athenahealth.com
  • Direct secure messaging: kwoss1240411@adventhealth.direct-ci.com

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 4

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": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1073968418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 PARK AVE STE 102",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605141494",
            "telephone_number": "630-455-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 PARK AVE STE 102",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605141494",
            "telephone_number": "630-455-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOSS",
        "first_name": "KERRY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036149704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kerry.woss.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "99 Park Ave Ste 102",
            "city": "Clarendon Hills",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605141494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "MATNEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarendon Hills, IL

Sources for this page

Verify at the official NPI Registry.