Individual provider Active NPI

Kristin Paul

  • Family Nurse Practitioner
  • Bloomington, IL
National Provider Identifier
1124411673
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209011827 Issued in IL
Practice address
720 W Chestnut St
Bloomington, IL 61701-2814
Phone
(309) 824-6026
NPI assigned
Mar 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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 209011827 IL Primary

Addresses

Primary practice location

720 W Chestnut St
Bloomington, IL 61701-2814

Mailing address

720 W Chestnut St
Bloomington, IL 61701-2814
Phone (309) 824-6026

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
I20180309000147 IL Practitioner - Nurse Practitioner 3870854789 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

3024 E Empire St
Bloomington, IL 61704-5402

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Bromenn Medical Center Hospital, Normal, IL, CCN 140127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carle West Physician Group Inc CurrentSince Jul 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Chestnut Health Systems Inc CurrentSince Jan 24, 2018 Accepting new patients
Carle Health Care Incorporated CurrentSince Oct 4, 2025 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 13, 2018 Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Jul 13, 2018 Accepting new patients
Chestnut Health Systems Inc. CurrentSince Jan 24, 2018 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

720 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

1003 Martin Luther King Dr
Bloomington, IL 61701
Phone (309) 827-6026

702 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352

29373 Network Pl
Chicago, IL 60673

50 Northgate Industrial Dr
Granite City, IL 62040
Phone (618) 512-1919

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 8

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 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": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1124411673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W CHESTNUT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617012814",
            "telephone_number": "309-824-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W CHESTNUT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617012814",
            "telephone_number": "309-824-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.