Individual provider Active NPI

Kayla R Deters, APN, FNP-BC

  • Family Nurse Practitioner
  • Effingham, IL
National Provider Identifier
1376051292
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209016977 Issued in IL
Practice address
1303 W Evergreen Ave Ste 200
Effingham, IL 62401-1638
Phone
(217) 342-3400
Fax
(217) 342-6417
NPI assigned
Jan 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209016977 IL
Family Nurse Practitioner 363LF0000X 209016977 IL Primary

Addresses

Primary practice location

1303 W Evergreen Ave Ste 200
Effingham, IL 62401-1638

Mailing address

1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653
Phone (217) 868-2812

Other practice location 1

1000 Health Center Dr
Mattoon, IL 61938-9261
Phone (217) 258-2525

Other practice location 2

100 Deerpath
Charleston, IL 61920-9427
Phone (217) 238-4982

Other names 1

  • Kayla R Foor Former name

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
I20180427001445 IL Practitioner - Nurse Practitioner 9436413457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

1303 W Evergreen Ave
Suite 200
Effingham, IL 62401-1638
Phone (217) 342-3400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209016977ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince Dec 29, 2018 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Sarah Bush Lincoln Health Center Past Accepting new patients

Locations

100 Deerpath
Charleston, IL 61920
Phone (217) 345-2727

1303 W Evergreen Ave
Ste 200
Effingham, IL 62401
Phone (217) 342-3400

1007 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-7400

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1376051292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DR STE 201",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384653",
            "telephone_number": "217-868-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 W EVERGREEN AVE STE 200",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011638",
            "telephone_number": "217-342-3400",
            "fax_number": "217-342-6417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619389261",
            "country_code": "US",
            "telephone_number": "217-258-2525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Deerpath",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "IL",
            "postal_code": "619209427",
            "country_code": "US",
            "telephone_number": "217-238-4982",
            "fax_number": "217-348-6345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DETERS",
        "first_name": "KAYLA",
        "middle_name": "R",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209016977",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209016977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "FOOR",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Effingham, IL

Sources for this page

Verify at the official NPI Registry.