Individual provider Active NPI

Kahla Jean Maurer

  • Family Nurse Practitioner
  • Hopedale, IL
National Provider Identifier
1336830652
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.026951 Issued in IL
Practice address
143 Ford Ave
Hopedale, IL 61747-9485
Phone
(309) 449-3336
NPI assigned
May 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.026951 IL Primary

Addresses

Primary practice location

143 Ford Ave
Hopedale, IL 61747-9485

Mailing address

12 Summerset Dr
Mackinaw, IL 61755-9772
Phone (309) 241-7685

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
I20230608001181 IL Practitioner - Nurse Practitioner 9133586035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

143 Ford Ave
Hopedale, IL 61747-9485
Phone (309) 449-3336

Hospital & facility affiliations

  • St. Francis Medical Center Home health agency, Peoria, IL, CCN 147243
  • Osf Home Health-Eastern Region Home health agency, Bloomington, IL, CCN 147451
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
  • Hopedale Hospital Hospital, Hopedale, IL, CCN 141330
  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.026951ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 25, 2023 Accepting new patients

Locations

143 Ford Ave
Hopedale, IL 61747
Phone (309) 449-3336

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1336830652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SUMMERSET DR",
            "city": "MACKINAW",
            "state": "IL",
            "postal_code": "617559772",
            "telephone_number": "309-241-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 FORD AVE",
            "city": "HOPEDALE",
            "state": "IL",
            "postal_code": "617479485",
            "telephone_number": "309-449-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURER",
        "first_name": "KAHLA",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.026951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopedale, IL

Sources for this page

Verify at the official NPI Registry.