Individual provider Active NPI

Naomi May Kern, CNP

  • Adult Health Nurse Practitioner
  • Elmhurst, IL
National Provider Identifier
1124384227
Registry record updated Sep 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209009472 Issued in IL
Practice address
977 N Oaklawn Ave
Suite 104
Elmhurst, IL 60126-1045
Phone
(630) 832-1775
NPI assigned
Apr 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209009472 IL Primary

Addresses

Primary practice location

977 N Oaklawn Ave
Suite 104
Elmhurst, IL 60126-1045

Mailing address

977 N Oaklawn Ave
Suite 104
Elmhurst, IL 60126-1045
Phone (630) 832-1775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131010002058 IL Practitioner - Nurse Practitioner 2466686191 Reassigns benefits to 1 organization
I20210728001945 IN Practitioner - Nurse Practitioner 2466686191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209009472ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical Midwest, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1124384227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 N OAKLAWN AVE",
            "address_2": "SUITE 104",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261045",
            "telephone_number": "630-832-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 N OAKLAWN AVE",
            "address_2": "SUITE 104",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261045",
            "telephone_number": "630-832-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "NAOMI",
        "middle_name": "MAY",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209009472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.