Individual provider Active NPI

Kaitlyn Juilfs, NP

  • Family Nurse Practitioner
  • Glen Carbon, IL
National Provider Identifier
1376267666
Registry record updated Mar 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209026034 Issued in IL
Practice address
4802 S. Il-159
Glen Carbon, IL 62034
Phone
(618) 451-0500
NPI assigned
Sep 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 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 209026034 IL Primary

Addresses

Primary practice location

4802 S. Il-159
Glen Carbon, IL 62034

Mailing address

4802 S State Route 159
Glen Carbon, IL 62034-1904

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
I20221123000465 IL Practitioner - Nurse Practitioner 1759759756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Ahs Il Medical Group LLCGroup PAC ID 5496111676, 46 clinicians

Practice addresses (Care Compare)

4802 S State Route 159
Glen Carbon, IL 62034-1904
Phone (618) 288-4388

Hospital & facility affiliations

  • Gateway Regional Medical Center Hospital, Granite City, IL, CCN 140125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Il Medical Group LLC CurrentSince Aug 8, 2023 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

4802 S State Route 159
Glen Carbon, IL 62034
Phone 61828843883331

12 Ginger Creek Pkwy
Glen Carbon, IL 62034
Phone (618) 656-8200

4273 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-2297

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

3912 Maryville Rd
Granite City, IL 62040
Phone (618) 931-1335

2100 Madison Ave
Ste 301
Granite City, IL 62040

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

509 Hamacher St
Ste 202
Waterloo, IL 62298
Phone (314) 997-1777

Interoperability endpoints

  • Direct secure messaging: kaitlyn.drost.1@28328.direct.athenahealth.com
  • Direct secure messaging: kdrost@yourcarecommunity.org

Organizations & group practices 1

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": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677974400000",
    "number": "1376267666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 S STATE ROUTE 159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 S. IL-159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "62034",
            "telephone_number": "618-451-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUILFS",
        "first_name": "KAITLYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209026034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

Verify at the official NPI Registry.