Individual provider Active NPI

Kayla Carey, PHMNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Loves Park, IL
National Provider Identifier
1194291252
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
277001672 Issued in IL
Practice address
1752 Windsor Rd Ste 203
Loves Park, IL 61111-4276
Phone
(815) 986-1113
Fax
(815) 986-1119
NPI assigned
Oct 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209018911 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277001672 IL Primary

Addresses

Primary practice location

1752 Windsor Rd Ste 203
Loves Park, IL 61111-4276

Mailing address

1752 Windsor Rd Ste 203
Loves Park, IL 61111-4276
Phone (815) 986-1113

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200722001559 IL Practitioner - Nurse Practitioner 7214351394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geiger Psychiatric Care LLCGroup PAC ID 1557312154, 9 clinicians

Practice addresses (Care Compare)

6377 Sebring Way
Loves Park, IL 61111-8609
Phone (815) 986-1113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Geiger Psychiatric Care LLC CurrentSince Jul 1, 2020 Accepting new patients
Progressive Chiropractic Wellness & Rehab Centre, P.C. PastSince Jul 1, 2020 Accepting new patients

Locations

1752 Windsor Rd
Ste 203
Loves Park, IL 61111
Phone (815) 986-1113

6377 Sebring Way
Loves Park, IL 61111
Phone (815) 636-2225

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1194291252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 WINDSOR RD STE 203",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114276",
            "telephone_number": "815-986-1113",
            "fax_number": "815-986-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 WINDSOR RD STE 203",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114276",
            "telephone_number": "815-986-1113",
            "fax_number": "815-986-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAREY",
        "first_name": "KAYLA",
        "name_prefix": "Mrs.",
        "credential": "PHMNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209018911",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277001672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

Verify at the official NPI Registry.