Active NPI
Melissa K Kenter, APN
- Family Nurse Practitioner
- Charleston, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 277000346
- Practice address
- 2040 Lincoln Ave Ste 100
Charleston, IL 61920-3197 - Phone
- (217) 345-2030
- Fax
- (217) 345-2045
- NPI assigned
- Jan 21, 2015
- Last updated
- Dec 10, 2024
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 277000346 | IL | Primary |
Addresses
Primary practice location
2040 Lincoln Ave Ste 100
Charleston, IL 61920-3197
Mailing address
PO Box 372
Mattoon, IL 61938-0372
Other practice location 1
1100 Tuscola Blvd
Tuscola, IL 61953-2065
Phone (217) 253-4764
Other practice location 2
1303 W Evergreen Ave Ste 201
Effingham, IL 62401-1638
Phone (217) 347-1422
Other practice location 3
1201 Wooddell Way Ste B
Mattoon, IL 61938-1014
Phone (217) 238-3000
Other practice location 4
1303 W Evergreen Ave Ste 100
Effingham, IL 62401-1638
Phone (217) 540-6123
Other names 1
- Melissa K Paholke
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
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 Professional PLZ
Mattoon, IL 61938-9252
Phone (217) 238-3730
1303 W Evergreen Ave
Effingham, IL 62401-1638
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.96 of 100
- Quality
- 69.5
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277000346 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Sarah Bush Lincoln Health Center | Past | Accepting new patients |
Locations
2040 Lincoln Ave
Ste 100
Charleston, IL 61920
Phone (217) 345-2030
1303 W Evergreen Ave
Ste 100
Effingham, IL 62401
Phone (217) 540-6123
1303 W Evergreen Ave
Ste 200
Effingham, IL 62401
Phone (217) 342-3400
1303 W Evergreen Ave
Ste 201
Effingham, IL 62401
Phone (217) 347-1422
1000 Red Ball Trl
Greenville, IL 62246
Phone (618) 391-6495
1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389
1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055
101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730
1201 Wooddell Way
Ste B
Mattoon, IL 61938
Phone (217) 238-3000
1100 Tuscola Blvd
Tuscola, IL 61953
Phone (217) 253-2020
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
-
dba FCH Greenville Family Medicine Clinic
- Rural Health Clinic/Center
- Greenville, IL
- NPI 1811858970
-
dba FCH Physician Billing
- Critical Access Hospital
- Vandalia, IL
- NPI 1912988734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1295124766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 372",
"city": "MATTOON",
"state": "IL",
"postal_code": "619380372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 LINCOLN AVE STE 100",
"city": "CHARLESTON",
"state": "IL",
"postal_code": "619203197",
"telephone_number": "217-345-2030",
"fax_number": "217-345-2045"
}
],
"practiceLocations": [
{
"address_1": "1100 Tuscola Blvd",
"address_purpose": "LOCATION",
"city": "Tuscola",
"state": "IL",
"postal_code": "619532065",
"country_code": "US",
"telephone_number": "217-253-4764",
"fax_number": "217-253-4886",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1303 W Evergreen Ave Ste 201",
"address_purpose": "LOCATION",
"city": "Effingham",
"state": "IL",
"postal_code": "624011638",
"country_code": "US",
"telephone_number": "217-347-1422",
"fax_number": "217-342-3402",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1201 Wooddell Way Ste B",
"address_purpose": "LOCATION",
"city": "Mattoon",
"state": "IL",
"postal_code": "619381014",
"country_code": "US",
"telephone_number": "217-238-3000",
"fax_number": "217-238-3008",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1303 W Evergreen Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Effingham",
"state": "IL",
"postal_code": "624011638",
"country_code": "US",
"telephone_number": "217-540-6123",
"fax_number": "217-347-4969",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENTER",
"first_name": "MELISSA",
"middle_name": "K",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-21",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "277000346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "PAHOLKE",
"middle_name": "K",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Charleston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.
- 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.