Individual provider Active NPI

Kisha Turner, FNP-BC

  • Nurse Practitioner
  • Freeport, IL
National Provider Identifier
1083045231
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-011119 Issued in IL
Practice address
1045 W Stephenson St
Freeport, IL 61032-4864
Phone
(815) 599-6105
NPI assigned
Dec 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 16747230 WI
Registered Nurse 163W00000X 041355450 IL
Nurse Practitioner 363L00000X 209-011119 IL Primary

Addresses

Primary practice location

1045 W Stephenson St
Freeport, IL 61032-4864

Mailing address

PO Box 1567
Rockford, IL 61110-0067

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
I20140318001227 IL Practitioner - Nurse Practitioner 2769613694 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeport Memorial HospitalGroup PAC ID 8426958232, 168 clinicians
Rochelle Community Hospital AssociationGroup PAC ID 4789581828, 27 clinicians

Practice addresses (Care Compare)

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

900 N 2ND St
Rochelle, IL 61068-1764
Phone (815) 562-2181

Hospital & facility affiliations

  • FHN Memorial Hospital Hospital, Freeport, IL, CCN 140160
  • Rochelle Community Hospital Hospital, Rochelle, IL, CCN 141312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041355450ILMDRegistered Nurse
16747230WIMDRegistered Nurse
209-011119ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jan 31, 2020 Accepting new patients
Cepamerica Illinois LLP Current Accepting new patients
Rochelle Community Hospital Association Nurse Practitioner Current Accepting new patients
Cepamerica Illinois LLP CurrentSince Aug 1, 2020 Accepting new patients
Rochelle Community Hospital Association CurrentSince Feb 6, 2019 Accepting new patients
Cepamerica Illinois LLP CurrentSince Aug 1, 2020 Accepting new patients
Freeport Memorial Hospital CurrentSince Jul 5, 2017 Accepting new patients
Rochelle Community Hospital Association CurrentSince Feb 6, 2019 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105

900 N 2nd St
Ste 200
Rochelle, IL 61068
Phone (815) 562-2181

900 N 2nd St
Rochelle, IL 61068
Phone (815) 562-2181

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

Organizations & group practices 9

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.

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": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1083045231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1567",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611100067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 W STEPHENSON ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324864",
            "telephone_number": "815-599-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNER",
        "first_name": "KISHA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "16747230",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041355450",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-011119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

Verify at the official NPI Registry.