Active NPI
Kimberly K Lopez
- Family Nurse Practitioner
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209014626
- Practice address
- 5401 N Knoxville Ave
Suite 416
Peoria, IL 61614-5098 - Phone
- (309) 692-7246
- NPI assigned
- Aug 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209014626 | IL | Primary |
Addresses
Primary practice location
5401 N Knoxville Ave
Suite 416
Peoria, IL 61614-5098
Mailing address
5401 N Knoxville Ave
Suite 416
Peoria, IL 61614-5098
Phone (309) 692-7246
Other names 1
- Kimberly K Peterson
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Methodist Medical Center of Illinois
Practice addresses (Care Compare)
600 S 13TH St
Pekin, IL 61554-4936
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
900 Main St
Suite 780
Peoria, IL 61602-1067
Phone (309) 672-5950
Hospital & facility affiliations
- Carle Health Methodist Hospital
- Carle Health Pekin Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.5 of 100
- Quality
- 93.83
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Medical Center of Illinois | Family | Current | Accepting new patients |
| Bond Eye Associates, SC | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Carle Health Care Incorporated | Current | Accepting new patients | |
| Millennium Pain Center LLC | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Pekin Prohealth Inc | Current | Accepting new patients | |
| Bond Eye Associates, S.C. | Past | Accepting new patients | |
| Millennium Pain Center of Lake County | Past | Accepting new patients | |
| Southwest Pain & Spine Center LLC | Past | Accepting new patients |
Locations
1015 S Mercer Ave
Bloomington, IL 61701
Phone (309) 662-0088
5198 Reliable Pkwy
Chicago, IL 60686
725 S 14th St
Pekin, IL 61554
Phone (309) 353-1579
600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151
600 S 13th St
Ste E
Pekin, IL 61554
Phone (309) 353-0473
112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402
5401 N Knoxville Ave
Ste 416
Peoria, IL 61614
Phone (309) 643-6206
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986
900 Main St
Ste 780
Peoria, IL 61602
Phone (309) 672-4908
6800 N Knoxville Ave
Peoria, IL 61614
Phone (309) 692-2020
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- kimberly.lopezaprn.p1@direct.bondeye.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- klopezaprn388464@carlehiedirect.net
Organizations & group practices 10
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.
-
- Optician
- Canton, IL
- NPI 1104025485
-
- Pain Clinic/Center
- Libertyville, IL
- NPI 1629373774
-
- Specialist
- Queen Creek, AZ
- NPI 1811369358
Hospital & facility affiliations 2
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": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471305600000",
"number": "1154876498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 N KNOXVILLE AVE",
"address_2": "SUITE 416",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145098",
"telephone_number": "309-692-7246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 N KNOXVILLE AVE",
"address_2": "SUITE 416",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145098",
"telephone_number": "309-692-7246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "KIMBERLY",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-16",
"last_updated": "2016-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209014626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "PETERSON",
"middle_name": "K",
"credential": "APN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.