Active NPI
Michele Krieger-Johnsen
- Nurse Practitioner
- Bloomington, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 041-304463
- Practice address
- 1505 Eastland Dr
Bloomington, IL 61701-7905 - Phone
- (309) 663-2100
- Fax
- (309) 663-8322
- NPI assigned
- Jul 2, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 041-304463 | IL | Primary |
Addresses
Primary practice location
1505 Eastland Dr
Bloomington, IL 61701-7905
Mailing address
1505 Eastland Dr
Bloomington, IL 61701-7905
Phone (309) 663-2100
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-304463 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Saint James Hospital | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Saint James Hospital | Current | Accepting new patients | |
| Saint James Hospital | Past | Accepting new patients |
Locations
1505 Eastland Dr
Ste 1000
Bloomington, IL 61701
Phone (309) 661-6270
1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100
1701 E College Ave
Bloomington, IL 61704
Phone (309) 664-3000
1505 Eastland Dr
Ste 350
Bloomington, IL 61701
Phone (309) 663-1222
1505 Eastland Dr
Ste 320
Bloomington, IL 61701
Phone (309) 661-2368
1505 Eastland Dr
Ste 1100
Bloomington, IL 61701
Phone (309) 663-2100
100 Delaney Dr
El Paso, IL 61738
Phone (309) 527-2260
801 Fox Run
Heyworth, IL 61745
Phone (309) 473-2069
2200 Fort Jesse Rd
Ste 100
Normal, IL 61761
Phone (309) 661-6280
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828
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.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
dba Saint James Hospital - Multiple Hospital Departments
- Anesthesiology Physician
- Pontiac, IL
- NPI 1790735421
-
dba OSF Healthcare - Medical Group - Roanoke
- Rural Health Clinic/Center
- Roanoke, IL
- NPI 1164138848
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
dba OSF Healthcare - Medical Group - Pontiac
- Rural Health Clinic/Center
- Pontiac, IL
- NPI 1447976113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435795200000",
"number": "1205219607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 EASTLAND DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617017905",
"telephone_number": "309-663-2100",
"fax_number": "309-663-8322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 EASTLAND DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617017905",
"telephone_number": "309-663-2100",
"fax_number": "309-663-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIEGER-JOHNSEN",
"first_name": "MICHELE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-02",
"last_updated": "2015-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "041-304463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.