Individual provider Active NPI

Kristina Stevens, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1255734869
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
277.000645 Issued in IL
Practice address
912 S Wood St
Chicago, IL 60612-4300
Phone
(312) 996-2200
NPI assigned
Sep 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 377.000624 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.011740 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277.000645 IL Primary

Addresses

Primary practice location

912 S Wood St
Chicago, IL 60612-4300

Mailing address

912 S Wood St
Chicago, IL 60612-4300

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
I20150112000876 IL Practitioner - Nurse Practitioner 6901120468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232
Phone (312) 996-7383

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.011740ILMDPsychiatric/Mental Health Nurse Practitioner
277.000645ILMDPsychiatric/Mental Health Nurse Practitioner
377.000624ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Dec 15, 2014 Accepting new patients
The Board of Trustees of the University of Illinois Psychiatric/Mental Health CurrentSince Dec 15, 2014 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

912 S Wood St
#1
Chicago, IL 60612
Phone (312) 996-1757

912 S Wood St
Chicago, IL 60612
Phone (312) 996-2200

835 S Wolcott Ave
Rm W140
Chicago, IL 60612

7825 Solution Ctr
Chicago, IL 60677

Interoperability endpoints

  • Direct secure messaging: kstevens17505@uihealth.direct-ci.com

Organizations & group practices 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1255734869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124300",
            "telephone_number": "312-996-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KRISTINA",
        "name_prefix": "Ms.",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-27",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "377.000624",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.011740",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277.000645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.