Individual provider Active NPI

Kristin Hagopian, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Litchfield, IL
National Provider Identifier
1356169783
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209030616 Issued in IL
Practice address
1365 E Union Ave
Litchfield, IL 62056-1768
Phone
(217) 969-1365
Fax
(833) 471-2122
NPI assigned
Oct 3, 2024
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209030616 IL Primary

Addresses

Primary practice location

1365 E Union Ave
Litchfield, IL 62056-1768

Mailing address

1365 E Union Ave
Litchfield, IL 62056-1768
Phone (217) 969-1365

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
I20241106002556 IL Practitioner - Nurse Practitioner 0042744559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innovative Women's Healthcare, PLLCGroup PAC ID 7719342187, 3 clinicians

Practice addresses (Care Compare)

2016 Vadalabene Dr
Suite D
Maryville, IL 62062-6901
Phone (618) 391-7030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209030616ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Women's Healthcare, PLLC CurrentSince Jan 1, 2026 Accepting new patients
Psychiatric Urgent Care LLC CurrentSince Oct 6, 2024 Accepting new patients
Southern Illinois Associates LLC CurrentSince Oct 11, 2024 Accepting new patients

Locations

1365 E Union Ave
Litchfield, IL 62056
Phone (217) 969-1365

2016 Vadalabene Dr
Ste D
Maryville, IL 62062
Phone (618) 391-7030

6805 Highway 162
#201
Maryville, IL 62062
Phone (618) 288-5019

6805 State Route 162
Maryville, IL 62062
Phone (618) 288-5019

6805 State Route 162
#201
Maryville, IL 62062
Phone (618) 288-5019

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17590/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/2183/brand/21/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/AFHDDD

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": "1727913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1356169783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 E UNION AVE",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620561768",
            "telephone_number": "217-969-1365",
            "fax_number": "833-471-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 E UNION AVE",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620561768",
            "telephone_number": "217-969-1365",
            "fax_number": "833-471-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGOPIAN",
        "first_name": "KRISTIN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-03",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209030616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield, IL

Sources for this page

Verify at the official NPI Registry.