Individual provider Active NPI

Douglas M. Kuhl, M.D.

  • Pediatrics Physician
  • Breese, IL
National Provider Identifier
1174732945
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036129742 Issued in IL
Practice address
9401 Holy Cross LN
Suite 112B
Breese, IL 62230-3510
Phone
(618) 526-7271
Fax
(618) 526-7313
NPI assigned
May 21, 2007
Last updated
Dec 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036129742 IL Primary

Addresses

Primary practice location

9401 Holy Cross LN
Suite 112B
Breese, IL 62230-3510

Mailing address

9401 Holy Cross LN
Suite 112B
Breese, IL 62230-3510
Phone (618) 526-7271

Other identifiers 2

IdentifierTypeStateIssuer
1513806MedicaidTN
4233422OtherTNBCBS TN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dkuhl157742@ewd.direct.hshs.org 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120430000636 IL Practitioner - Pediatric Medicine 3476605676 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036129742ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital Breese of the Hospital Sisters of the Third Orde Current Accepting new patients
HSHS Prairie, Inc CurrentSince Jul 1, 2016 Accepting new patients
St Josephs Hospital Breese of the Hospital Sisters of the Third Orde CurrentSince Apr 1, 2012 Accepting new patients
St Josephs Hospital Breese of the Hospital Sisters of the Third Orde CurrentSince Apr 1, 2012 Accepting new patients
HSHS Prairie, Inc CurrentSince Jul 1, 2016 Accepting new patients

Locations

9401 Holy Cross Ln
Breese, IL 62230
Phone (618) 526-5948

9401 Holy Cross Ln
#112
Breese, IL 62230
Phone (618) 526-7271

9401 Holy Cross Ln
Ste 112
Breese, IL 62230
Phone (618) 206-2082

9401 Holy Cross Ln
Ste 112B
Breese, IL 62230
Phone (618) 526-7271

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

9515 Holy Cross Ln
Saint Rose, IL 62230
Phone (618) 526-4511

Interoperability endpoints

  • Direct secure messaging: dkuhl157742@ewd.direct.hshs.org
  • Direct secure messaging: douglas.kuhl@ccrh.directbygreenway.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1174732945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 HOLY CROSS LN",
            "address_2": "SUITE 112B",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303510",
            "telephone_number": "618-526-7271",
            "fax_number": "618-526-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 HOLY CROSS LN",
            "address_2": "SUITE 112B",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303510",
            "telephone_number": "618-526-7271",
            "fax_number": "618-526-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUHL",
        "first_name": "DOUGLAS",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036129742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513806",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4233422",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dkuhl157742@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "9401 Holy Cross Ln",
            "address_2": "Suite 112B",
            "city": "Breese",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622303510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Breese, IL

Sources for this page

Verify at the official NPI Registry.