Kimberly V Teats-Garrison, PA-C
Individual provider Active NPI Physician Assistant · Fulton, IL
NPI 1164909164 · NPPES record last updated Jul 7, 2021
Key facts
- NPI
- 1164909164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 1130 17TH St Ste B
Fulton, IL 61252-2008 - Phone
- (815) 589-2005
- Fax
- (815) 632-5975
- NPI assigned
- Jul 23, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- CGH Medical Center
Practice addresses (Care Compare)
101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790
105 S Heaton St
Morrison, IL 61270-2007
Phone (815) 772-8100
1130 17TH St
Suite B
Fulton, IL 61252-2008
Phone (815) 589-2005
212 E Railroad St
Prophetstown, IL 61277-1222
Phone (815) 537-5050
Hospital & facility affiliations
- CGH Medical Center
- Morrison Community Hospital
- Mercyone Clinton Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180925002336 | IL | Practitioner - Physician Assistant | 0345591673 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CGH Medical Center | Current |
Accepting new patients | |
| CGH Medical Center | Past | Accepting new patients |
Locations
1130 17th St
Ste B
Fulton, IL 61252
Phone (815) 589-2005
105 S Heaton St
Morrison, IL 61270
Phone (815) 284-1600
101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285
Interoperability endpoints
- kteatsgarrison20466@cghmc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
1130 17TH St Ste B
Fulton, IL 61252-2008
Mailing address
915 13TH Ave N
Clinton, IA 52732-5099
Phone (563) 243-2511
Other practice location 1
1705 16th Ave
Fulton, IL 61252-9708
Phone (815) 589-2121
Other names
- Kimberly V Teats
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kimberly.teatsgarrison.p1@direct.cghmc.nextgenshare.com |
Other providers in Fulton, IL
- Kimberly K Mulholland
- Osteopractic Physical Therapy of the Midwest
- River Bend Cusd 2
- Emily Mae Santana
- Elizabeth Katherine Stoltz
- TJT Pharmacy, Inc
- Cynthia Dawn Treharne
- Adrianna Vanduyne
- Whiteside County Community Health Clinic
- Whiteside County Community Health Clinic
All providers in Fulton, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.