Individual provider Active NPI

Renee Lynn Keeney, CNM

  • Advanced Practice Midwife
  • Rockford, IL
National Provider Identifier
1205115383
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
1200 W. State Street
Crusader Community Health
Rockford, IL 61102
Phone
(815) 490-1600
Fax
(815) 490-1485
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X IL Primary

Addresses

Primary practice location

1200 W. State Street
Crusader Community Health
Rockford, IL 61102

Mailing address

1200 W State St
Rockford, IL 61102-2112
Phone (815) 490-1600

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130213000041 IL Practitioner - Certified Nurse Midwife (CNM) 3072767466 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Crusaders Central Clinic Association Current Accepting new patients
Crusaders Central Clinic Association CurrentSince Nov 1, 2012 Accepting new patients
Crusaders Central Clinic Association CurrentSince Nov 1, 2012 Accepting new patients

Locations

1050 Logan Ave
Belvidere, IL 61008
Phone (815) 547-0282

6115 N 2nd St
Loves Park, IL 61111
Phone (815) 516-0040

1215 N Alpine Rd
Rockford, IL 61107
Phone (815) 391-7700

1200 W State St
Rockford, IL 61102

1100 Broadway
Rockford, IL 61104
Phone (815) 490-1354

Organizations & group practices 3

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": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1205115383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611022112",
            "telephone_number": "815-490-1600",
            "fax_number": "815-490-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W. STATE STREET",
            "address_2": "CRUSADER COMMUNITY HEALTH",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61102",
            "telephone_number": "815-490-1600",
            "fax_number": "815-490-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENEY",
        "first_name": "RENEE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.