Active NPI
Kyle Higdon
- Certified Registered Nurse Anesthetist
- Herrin, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 209.012449
- Practice address
- 201 S 14TH St
Herrin, IL 62948-3631 - Phone
- (618) 942-2171
- Fax
- (618) 351-4919
- NPI assigned
- Jan 5, 2015
- Last updated
- Jun 4, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 209.012449 | IL | Primary |
| Registered Nurse | 163W00000X | 041424312 | IL |
Addresses
Primary practice location
201 S 14TH St
Herrin, IL 62948-3631
Mailing address
PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 942-2171
Other practice location 1
2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156 ext. 65137
Other practice location 2
510 Lincoln Dr
Herrin, IL 62948-6334
Phone (618) 997-6800 ext. 1125
Other practice location 3
405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721 ext. 65137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 614881 | Other | IL | MULTISPECIALTY GROUP PTAN |
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | khigdon14137@sih.direct-ci.com | ||
| Direct Messaging Address | khigdon14137@sih.direct-ci.com | ||
| Direct Messaging Address | khigdon14137@sih.direct-ci.com | ||
| Direct Messaging Address | khigdon14137@sih.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
117 E Clark St
Harrisburg, IL 62946-2702
Phone (618) 252-0411
1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000
2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156
201 S 14TH St
Herrin, IL 62948-3631
Phone (618) 942-2171
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041424312 | IL | MD | Registered Nurse |
| 209.012449 | IL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Anesthesiologists, S.C. | Current | Accepting new patients | |
| Southern Illinois Medical Services, NFP | Current | Accepting new patients | |
| Northstar Anesthesia of Illinois, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Associated Anesthesiologists, SC | Past | Accepting new patients |
Locations
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
405 W Jackson St
Carbondale, IL 62901
405 W Jackson St
#Sih
Carbondale, IL 62901
Phone 6185490721 ext. 65137
201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171
510 Lincoln Dr
Herrin, IL 62948
Phone (618) 997-3100
510 Lincoln Dr
#Sih
Herrin, IL 62948
Phone 6189976800 ext. 1125
2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156
2 S Hospital Dr
#Sih
Murphysboro, IL 62966
Phone 6186843156 ext. 65137
530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393
6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393
8800 State Route 91
Peoria, IL 61615
Phone (309) 683-5000
1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160
Interoperability endpoints
- khigdon14137@sih.direct-ci.com
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Arlington, TX
- NPI 1962822395
IL, Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1558306480
-
dba SIH Medical Group
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1023612082
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Harrisburg, IL
- NPI 1073580130
-
dba Memorial Hospital of Carbondale
- General Acute Care Hospital
- Carbondale, IL
- NPI 1093801797
-
dba Herrin Hospital
- General Acute Care Hospital
- Herrin, IL
- NPI 1528158573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622764800000",
"number": "1235527854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3988",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629023988",
"telephone_number": "618-942-2171",
"fax_number": "618-351-4919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S 14TH ST",
"city": "HERRIN",
"state": "IL",
"postal_code": "629483631",
"telephone_number": "618-942-2171",
"fax_number": "618-351-4919"
}
],
"practiceLocations": [
{
"address_1": "2 S Hospital Dr",
"address_purpose": "LOCATION",
"city": "Murphysboro",
"state": "IL",
"postal_code": "629663333",
"country_code": "US",
"telephone_number": "618-684-3156 x65137",
"fax_number": "618-529-0529",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "510 Lincoln Dr",
"address_purpose": "LOCATION",
"city": "Herrin",
"state": "IL",
"postal_code": "629486334",
"country_code": "US",
"telephone_number": "618-997-6800 x1125",
"fax_number": "618-993-8188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "405 W Jackson St",
"address_purpose": "LOCATION",
"city": "Carbondale",
"state": "IL",
"postal_code": "629011462",
"country_code": "US",
"telephone_number": "618-549-0721 x65137",
"fax_number": "618-529-0449",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HIGDON",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-05",
"last_updated": "2021-06-04",
"certification_date": "2021-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "209.012449",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041424312",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTISPECIALTY GROUP PTAN",
"identifier": "614881",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "khigdon14137@sih.direct-ci.com",
"affiliation": "N",
"address_1": "510 Lincoln Drive",
"address_2": "SIH Medical Group Anesthesiology",
"city": "Herrin",
"state": "IL",
"country_code": "US",
"postal_code": "62948",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "khigdon14137@sih.direct-ci.com",
"affiliation": "N",
"address_1": "201 S 14th Street",
"address_2": "SIH Medical Group Anesthesiology",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629037647",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "khigdon14137@sih.direct-ci.com",
"affiliation": "N",
"address_1": "405 W Jackson Street",
"address_2": "SIH Medical Group Anesthesiology",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "62901",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "khigdon14137@sih.direct-ci.com",
"affiliation": "N",
"address_1": "2 South Hospital Drive",
"address_2": "SIH Medical Group Anesthesiology",
"city": "Murphysboro",
"state": "IL",
"country_code": "US",
"postal_code": "62966",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Herrin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.