Individual provider Active NPI

Kaylee Marie Beals, DNP, APRN FNP-BC

  • Family Nurse Practitioner
  • Effingham, IL
National Provider Identifier
1093429300
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209028709 Issued in IL
Practice address
905 Medical Park Dr
Effingham, IL 62401-2190
Phone
(217) 342-2066
Fax
(217) 342-2074
NPI assigned
Jan 11, 2023
Last updated
Jul 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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 209028709 IL Primary

Addresses

Primary practice location

905 Medical Park Dr
Effingham, IL 62401-2190

Mailing address

905 Medical Park Dr
Effingham, IL 62401-2190
Phone (217) 342-2066

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
I20240819002097 IL Practitioner - Nurse Practitioner 0244778470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Southern Illinois University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

905 Medical Park Dr
Effingham, IL 62401-2190
Phone (217) 342-2066

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209028709ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Care Specialists of Central Illinois, S.C CurrentSince Jul 8, 2024 Accepting new patients
Cancer Care Specialists of Central Illinois, S.C. CurrentSince Jul 8, 2024 Accepting new patients

Locations

210 W McKinley Ave
#1
Decatur, IL 62526
Phone (217) 877-9442

905 Medical Park Dr
Effingham, IL 62401
Phone (217) 342-2066

929 Stacey Burk Dr
Flora, IL 62839

800 E Locust St
Olney, IL 62450
Phone (618) 395-2131

650 W Taylor St
Vandalia, IL 62471
Phone (618) 283-1231

Organizations & group practices 2

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 7

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": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1093429300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 MEDICAL PARK DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012190",
            "telephone_number": "217-342-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 MEDICAL PARK DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012190",
            "telephone_number": "217-342-2066",
            "fax_number": "217-342-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALS",
        "first_name": "KAYLEE",
        "middle_name": "MARIE",
        "credential": "DNP, APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

Verify at the official NPI Registry.