Individual provider Active NPI

Keanlynn M McWilliams, APN

  • Obstetrics & Gynecology Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1336638279
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
209-017726 Issued in IL
Practice address
7180 Spring Brook Rd
Rockford, IL 61114-6700
Phone
(779) 696-2750
NPI assigned
May 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 209-017726 IL Primary
Registered Nurse 163W00000X 041-399775 IL

Addresses

Primary practice location

7180 Spring Brook Rd
Rockford, IL 61114-6700

Mailing address

PO Box 1567
Rockford, IL 61110-0067

Other practice location 1

209 9th St Ste 200
Rockford, IL 61104
Phone (779) 696-2750

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmcwilliams914382@direct.uwhealth.org

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
I20180702001973 IL Practitioner - Nurse Practitioner 9931455185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041-399775ILMDRegistered Nurse
209-017726ILMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital Current Accepting new patients
Swedishamerican Hospital CurrentSince Jul 1, 2018 Accepting new patients
Swedishamerican Hospital CurrentSince Jul 1, 2018 Accepting new patients

Locations

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

209 9th St
Ste 200
Rockford, IL 61104
Phone (779) 696-2750

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

7180 Spring Brook Rd
Rockford, IL 61114
Phone (779) 696-2750

Interoperability endpoints

  • Direct secure messaging: kmcwilliams914382@direct.uwhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1336638279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1567",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611100067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7180 SPRING BROOK RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146700",
            "telephone_number": "779-696-2750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 9th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "61104",
            "country_code": "US",
            "telephone_number": "779-696-2750",
            "fax_number": "779-696-4196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "KEANLYNN",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IL",
            "license": "209-017726",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-399775",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmcwilliams914382@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "209 9th St Ste 200",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.