Individual provider Active NPI

Kellie Grapperhaus, APN

  • Family Nurse Practitioner
  • Louisville, IL
National Provider Identifier
1205188661
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209009894 Issued in IL
Practice address
935 Bryant St
Louisville, IL 62858-1053
Phone
(618) 665-4500
Fax
(618) 665-4050
NPI assigned
Oct 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209009894 IL Primary

Addresses

Primary practice location

935 Bryant St
Louisville, IL 62858-1053

Mailing address

935 Bryant St
Louisville, IL 62858-1053
Phone (618) 665-4500

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
I20171220003062 IL Practitioner - Nurse Practitioner 8123386117 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209009894ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Oct 12, 2019 Accepting new patients

Locations

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: kgrap@yourcarecommunity.org

Organizations & group practices 1

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": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1205188661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 BRYANT ST",
            "city": "LOUISVILLE",
            "state": "IL",
            "postal_code": "628581053",
            "telephone_number": "618-665-4500",
            "fax_number": "618-665-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 BRYANT ST",
            "city": "LOUISVILLE",
            "state": "IL",
            "postal_code": "628581053",
            "telephone_number": "618-665-4500",
            "fax_number": "618-665-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAPPERHAUS",
        "first_name": "KELLIE",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, IL

Sources for this page

Verify at the official NPI Registry.