Individual provider Active NPI

Katherine A Krall, CFNP

  • Family Nurse Practitioner
  • Petersburg, IL
National Provider Identifier
1104891092
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209000677 Issued in IL
Practice address
1 Centre Dr
Petersburg, IL 62675-9584
Phone
(217) 632-7761
Fax
(217) 632-0312
NPI assigned
Feb 22, 2006
Last updated
Jun 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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 209000677 IL Primary

Addresses

Primary practice location

1 Centre Dr
Petersburg, IL 62675-9584

Mailing address

1 Centre Dr
Petersburg, IL 62675-9584
Phone (217) 632-7761

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
I20060830000076 IL Practitioner - Nurse Practitioner 9537163894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Menard Medical Center, LLCGroup PAC ID 2769547090, 9 clinicians
Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Practice addresses (Care Compare)

1 Centre Dr
Petersburg, IL 62675-9467

101 E Plummer Blvd
Chatham, IL 62629-8047
Phone (217) 588-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209000677ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Physician Services CurrentSince Jan 1, 2013 Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Memorial Health Partners Current Accepting new patients
Memorial Physician Services Current Accepting new patients
Memorial Physician Services CurrentSince Jan 1, 2013 Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients
Midwest Emergency Department Specialists LTD Past Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

515 N College St
Lincoln, IL 62656
Phone (217) 732-9681

1 Centre Dr
Petersburg, IL 62675
Phone (217) 632-7599

3132 Old Jacksonville Rd
Springfield, IL 62704
Phone (217) 862-0062

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

Interoperability endpoints

  • Direct secure messaging: katherinekrall@memorial.allscriptsdirect.net
  • Direct secure messaging: katherinekrall@sfc.allscriptsdirect.net

Organizations & group practices 7

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 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1104891092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CENTRE DR",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626759584",
            "telephone_number": "217-632-7761",
            "fax_number": "217-632-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CENTRE DR",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626759584",
            "telephone_number": "217-632-7761",
            "fax_number": "217-632-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRALL",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209000677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, IL

Sources for this page

Verify at the official NPI Registry.