Individual provider Active NPI

Kelsey M Beard, FNP-BC, DNP

  • Family Nurse Practitioner
  • Alton, IL
National Provider Identifier
1124612445
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209025576 Issued in IL
Practice address
4 Memorial Dr Ste 210
Alton, IL 62002-6704
Phone
(618) 463-5905
Fax
(618) 463-5035
NPI assigned
Feb 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 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 209025576 IL Primary

Addresses

Primary practice location

4 Memorial Dr Ste 210
Alton, IL 62002-6704

Mailing address

4 Memorial Dr Ste 210
Alton, IL 62002-6704
Phone (618) 463-5905

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelsey.beard.1@9559.direct.athenahealth.com Direct

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
I20240603002910 IL Practitioner - Nurse Practitioner 4082156260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Illinois Healthcare Foundation IncGroup PAC ID 1456256874, 117 clinicians

Practice addresses (Care Compare)

4 Memorial Dr
Suite 210
Alton, IL 62002-6704
Phone (618) 463-5905

Hospital & facility affiliations

  • Osf Saint Anthony'S Health Center Hospital, Alton, IL, CCN 140052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation, Inc. CurrentSince Apr 22, 2024 Accepting new patients
Southern Illinois Healthcare Foundation Inc Current Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Apr 22, 2024 Accepting new patients

Locations

4 Memorial Dr
Ste 210
Alton, IL 62002
Phone (618) 463-5905

2 Saint Anthonys Way
Ste 101
Alton, IL 62002
Phone (618) 462-2222

2615 Edwards St
Alton, IL 62002
Phone (618) 462-2331

2 Terminal Dr
Ste 8
East Alton, IL 62024
Phone (618) 258-0485

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

2041 Goose Lake Rd
Sauget, IL 62206

Interoperability endpoints

  • Direct secure messaging: kelsey.beard.1@9559.direct.athenahealth.com

Organizations & group practices 3

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": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1124612445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 210",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-463-5905",
            "fax_number": "618-463-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 210",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-463-5905",
            "fax_number": "618-463-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARD",
        "first_name": "KELSEY",
        "middle_name": "M",
        "credential": "FNP-BC, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209025576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelsey.beard.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4 Memorial Dr Ste 210",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.