Kaci N Havlin

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209015784 Issued in IL

Practice address

15 Founders LN
Jacksonville, IL 62650-3919

Phone

(217) 528-7541

NPI assigned

Mar 20, 2017

Last updated

Oct 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaci N Ridder Other name

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring V Home health agency, Springfield, IL, CCN 148086
• Enhabit Home Health Home health agency, Springfield, IL, CCN 147708
• Jacksonville Memorial Hospital Hospital, Jacksonville, IL, CCN 141352
• Carlinville Area Hospital Hospital, Carlinville, IL, CCN 141347
• Memorial Medical Center Hospital, Springfield, IL, CCN 140148
• Thomas H Boyd Memorial Hospital Hospital, Carrollton, IL, CCN 141300

Merit-based Incentive Payment System (MIPS)

Final score

88.83 of 100Reported as apm

Quality

75.65

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaci.havlin.1@28977.direct.athenahealth.com

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.

• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  Medicare reassignment Care Compare group NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  Medicare reassignment

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

• Carlinville Area Hospital Association

  dba Carlinville Area Hospital

  • Critical Access Hospital
  • Carlinville, IL
  • NPI 1053425124
  Care Compare affiliation
• Eh Home Health of the Midwest, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Springfield, IL
  • NPI 1477006161
  Care Compare affiliation
• First Care Healthcare Inc.

  dba Elara Caring V

  • Home Health Agency
  • Springfield, IL
  • NPI 1780823377
  Care Compare affiliation
• Memorial Medical Center

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1255317590
  Care Compare affiliation
• Passavant Memorial Area Hospital Association

  dba Passavant Area Hospital

  • Critical Access Hospital
  • Jacksonville, IL
  • NPI 1174580831
  Care Compare affiliation
• Thomas H. Boyd Memorial Hospital

  • Critical Access Hospital
  • Carrollton, IL
  • NPI 1811096811
  Care Compare affiliation

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1083155311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FOUNDERS LN",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503919",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVLIN",
        "first_name": "KACI",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACI",
            "last_name": "RIDDER",
            "middle_name": "N",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kendra Hall
• Daniel M Hallam, M.D.
• Kevin William Harrington, D.M.D.
• Jennifer E Hart, PTA
• Christopher Bruce Haschemeyer, D.C.
• Healthcare Network Associates (Jacksonville Pediatric Associates)
• Healthcare Network Associates (Jacksonville Family Medical Associates)
• Healthcare Network Associates (Internal Medicine Clinic of Jacksonville)
• Healthcare Network Associates (Jacksonville Family Practice)
• Healthcare Network Associates of Sangamon (Jacksonville Pediatric Associates)

• Family Nurse Practitioner in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.

Verify at the official NPI Registry.