Individual provider Active NPI

Kathleen Montgomery, MSN, APRN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1346832011
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209.022480 Issued in IL
Practice address
747 N Rutledge St FL 4
Springfield, IL 62702-6700
Phone
(217) 545-8000
Fax
(217) 545-7053
NPI assigned
Feb 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209.022480 IL Primary

Addresses

Primary practice location

747 N Rutledge St FL 4
Springfield, IL 62702-6700

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000

Other practice location 1

701 N 1st St
Springfield, IL 62781-4829
Phone (217) 528-7541

Other practice location 2

619 E Mason St Ste 5
Springfield, IL 62701-1080
Phone (217) 545-8000

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
I20210602001256 IL Practitioner - Nurse Practitioner 3870992456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

747 N Rutledge St
Springfield, IL 62702-6700
Phone (217) 545-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.022480ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Sep 3, 2025 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Sep 3, 2025 Accepting new patients
Springfield Clinic LLP Current Accepting new patients

Locations

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

747 N Rutledge St
Fl 4
Springfield, IL 62702

619 E Mason St
Ste 5
Springfield, IL 62701

747 N Rutledge St
Springfield, IL 62702
Phone (217) 545-6112

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

1025 S 6th St
Springfield, IL 62703

Interoperability endpoints

  • Direct secure messaging: kathleenmontgomery@siusm.allscriptsdirect.net
  • Direct secure messaging: kathleenmontgomery@sfc.allscriptsdirect.net

Organizations & group practices 4

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 1

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": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1346832011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N RUTLEDGE ST FL 4",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026700",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627814829",
            "country_code": "US",
            "telephone_number": "217-528-7541",
            "fax_number": "217-606-3057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "619 E Mason St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627011080",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KATHLEEN",
        "credential": "MSN, APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.022480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.