Kaitlyn Ann Johnson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209030912 Issued in IL

Practice address

1418 College Dr
Mount Carmel, IL 62863-2638

Phone

(618) 553-4488

NPI assigned

Nov 27, 2024

Last updated

Nov 27, 2024By the provider in NPPES

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 Ann Knollenberg 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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wabash General Hospital DistrictGroup PAC ID 8022908185, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wabash General Hospital 1 Hospital, Mount Carmel, IL, CCN 141327

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wabash General Hospital District

  • General Practice Physician
  • Mount Carmel, IL
  • NPI 1295834208
  Medicare reassignment Care Compare group NPD
• Wabash General Hospital District

  dba Albion Medical Clinic

  • Rural Health Clinic/Center
  • Albion, IL
  • NPI 1689148892
  NPD
• Wabash General Hospital District

  dba Wabash Community Healht Center Counseling

  • Federally Qualified Health Center (FQHC)
  • Mount Carmel, IL
  • NPI 1922645910
  NPD
• Wabash General Hospital District

  • Critical Access Hospital
  • Mount Carmel, IL
  • NPI 1194728808
  NPD (past)

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

• Wabash General Hospital District

  • Critical Access Hospital
  • Mount Carmel, IL
  • NPI 1194728808
  Care Compare affiliation
• Wabash General Hospital District

  • Ambulance
  • Mount Carmel, IL
  • NPI 1194814178

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1184440794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 145",
            "city": "ALLENDALE",
            "state": "IL",
            "postal_code": "624100145",
            "telephone_number": "618-553-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 COLLEGE DR",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632638",
            "telephone_number": "618-553-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAITLYN",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209030912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "KNOLLENBERG",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Casey J Ikemire, MSN, APRN, FNP-BC
• Ma Jessica Sarah Veluya Isaac, PT, DPT
• James B O'Neal, Ms Amd Associates, PC
• Siddharth B Jani, M.D.
• Lawrence P Jennings, MD
• Kathleen Johnson, BS
• Marlon D Jordan, MD
• Srinath Kamineni, MD
• Lori Beth Kasinger
• Audra Keepes, PHARMD

• Family Nurse Practitioner in Mount Carmel, IL
• Providers in Mount Carmel, 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 Nov 27, 2024; 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.