Individual provider Active NPI

Kali Rae James, FNP-BC

  • Nurse Practitioner
  • Marion, IL
National Provider Identifier
1285350348
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209025832 Issued in IL
Practice address
3408 Office Park Dr
Marion, IL 62959-6477
Phone
(844) 872-6249
NPI assigned
Oct 19, 2022
Last updated
Oct 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209025832 IL Primary

Addresses

Primary practice location

3408 Office Park Dr
Marion, IL 62959-6477

Mailing address

3230 Veterans Memorial Dr
Mount Vernon, IL 62864-5950
Phone (877) 456-2496

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
I20231114001730 IL Practitioner - Nurse Practitioner 6103273032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amky Mso-1 PLLCGroup PAC ID 0446777114, 2 clinicians

Practice addresses (Care Compare)

1325 W Whittaker St
Suite D
Salem, IL 62881-2034
Phone (215) 684-9999

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209025832ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Asbery and Associates OB GYN LLC CurrentSince Dec 1, 2023 Accepting new patients
Amky Mso-1 PLLC CurrentSince Dec 13, 2025 Accepting new patients

Locations

4225 Lincolnshire Dr
Ste B
Mount Vernon, IL 62864

8 Cusumano Professional Plaza Dr
Mount Vernon, IL 62864
Phone (618) 242-7819

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

1325 W Whittaker St
Ste D
Salem, IL 62881
Phone (215) 684-9999

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1285350348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 VETERANS MEMORIAL DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628645950",
            "telephone_number": "877-456-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3408 OFFICE PARK DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596477",
            "telephone_number": "844-872-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "KALI",
        "middle_name": "RAE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209025832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.