Kaitlyn Tucker, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.020167 Issued in IL

Practice address

800 N 1St St
Springfield, IL 62702-3778

Phone

(217) 528-7541

NPI assigned

Nov 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaitlyn Stauffer Former name

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Medical Center Hospital, Springfield, IL, CCN 140148
• St Johns Hospital Hospital, Springfield, IL, CCN 140053
• Taylorville Memorial Hospital Hospital, Taylorville, IL, CCN 141339
• Pana Community Hospital Hospital, Pana, IL, CCN 141341
• Abraham Lincoln Memorial Hospital Hospital, Lincoln, IL, CCN 141322

Merit-based Incentive Payment System (MIPS)

Final score

88.83 of 100Reported as apm

Quality

75.65

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as apm

Quality

72.1

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaitlyn.tucker.1@28977.direct.athenahealth.com

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.

• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  Medicare reassignment Care Compare group NPD
• Pana Community Hospital Association

  • Critical Access Hospital
  • Pana, IL
  • NPI 1942326970
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Abraham Lincoln Memorial Hospital

  • Critical Access Hospital
  • Lincoln, IL
  • NPI 1154329753
  Care Compare affiliation
• Memorial Medical Center

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1255317590
  Care Compare affiliation
• Pana Community Hospital Association

  • Critical Access Hospital
  • Pana, IL
  • NPI 1942326970
  Care Compare affiliation
• St Johns Hospital of the Hospital Sisters of the Third Order of St F

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1205818481
  Care Compare affiliation
• Taylorville Memorial Hospital

  • Critical Access Hospital
  • Taylorville, IL
  • NPI 1144292020
  Care Compare affiliation

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1164068805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023778",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Knollwood Dr",
            "address_purpose": "LOCATION",
            "city": "Sherman",
            "state": "IL",
            "postal_code": "626849559",
            "country_code": "US",
            "telephone_number": "217-828-0764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KAITLYN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.020167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "STAUFFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bethany L Tschantz, FNP-BC
• Kevin Tu, DO
• Carrie S. Tucker, NURSE PRACTITIONER
• Christina Kay Tucker, FNP-BC
• Julie M Tucker, LCSW CADC
• Alisha Lynn Tudoreanu, PHARMD
• Kate Turasky
• Katie M Turley, LCSW
• Kelli Turner, PA-C
• Kurt Turner, ATC

• Family Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.

Verify at the official NPI Registry.