Individual provider Active NPI

Carol M Kadonsky, NP-C

  • Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1124326145
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209008700 Issued in IL
Practice address
4700 Memorial Dr Ste 350
Belleville, IL 62226-5373
Phone
(618) 235-7065
NPI assigned
Mar 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209008700 IL Primary

Addresses

Primary practice location

4700 Memorial Dr Ste 350
Belleville, IL 62226-5373

Mailing address

4700 Memorial Dr Ste 350
Belleville, IL 62226-5373
Phone (618) 235-7065

Other practice location 1

4700 Memorial Dr
Ste. 230
Belleville, IL 62226-5373
Phone (618) 257-5902

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20110609000042 IL Practitioner - Nurse Practitioner 4880871326 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1404 Cross St
Shiloh, IL 62269-2988
Phone (618) 607-3055

1418 Cross St
Suite 350
Shiloh, IL 62269-2988
Phone (618) 607-3900

4700 Memorial Dr
Belleville, IL 62226-5373

Hospital & facility affiliations

  • HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
  • Sparta Community Hospital Hospital, Sparta, IL, CCN 141349
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209008700ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP Current Accepting new patients
Fairview Heights Medical Group SC Current Accepting new patients
Emergency Services Midwest SC Nurse Practitioner CurrentSince May 1, 2018 Accepting new patients
Cepamerica Illinois LLP CurrentSince Jan 17, 2012 Accepting new patients
Cepamerica Illinois LLP CurrentSince Jan 17, 2012 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Dec 24, 2017 Accepting new patients

Locations

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

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4700 Memorial Dr
Ste 350
Belleville, IL 62226
Phone (618) 235-7065

4600 Memorial Dr
Ste 120
Belleville, IL 62226
Phone (618) 233-2220

4700 Memorial Dr
Ste 340
Belleville, IL 62226
Phone (618) 234-9884

4700 Memorial Dr
Ste 230
Belleville, IL 62226
Phone (618) 212-4414

4700 Memorial Dr
Ste 300
Belleville, IL 62226
Phone (618) 234-9884

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

1414 Cross St
Ste 110
Shiloh, IL 62269
Phone (618) 234-9884

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

Organizations & group practices 6

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 3

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": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1124326145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 MEMORIAL DR STE 350",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265373",
            "telephone_number": "618-235-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 MEMORIAL DR STE 350",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265373",
            "telephone_number": "618-235-7065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Memorial Dr",
            "address_2": "Ste. 230",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622265373",
            "country_code": "US",
            "telephone_number": "618-257-5902",
            "fax_number": "618-257-6671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KADONSKY",
        "first_name": "CAROL",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-01",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209008700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4700 Memorial Dr Ste 350",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.