Catherine Bachtold
Individual provider Active NPI Nurse Practitioner · Pontiac, IL
NPI 1376926832 · NPPES record last updated Jul 2, 2015
Key facts
- NPI
- 1376926832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 041-289555 (IL)
- Practice address
- 2500 W Reynolds St
Pontiac, IL 61764-9774 - Phone
- (815) 844-2001
- Fax
- (815) 842-6803
- NPI assigned
- Jul 2, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint James Hospital
Practice addresses (Care Compare)
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828
Hospital & facility affiliations
- Saint James Hospital
- Osf Saint Elizabeth MDL Ctr
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150828001477 | IL | Practitioner - Nurse Practitioner | 9234445735 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-289555 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint James Hospital | Current |
Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Saint James Hospital | Nurse Practitioner | Past | Accepting new patients |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
106 S 1st St
Fairbury, IL 61739
Phone (815) 635-3177
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
2500 W Reynolds St
Ste 205
Pontiac, IL 61764
2500 W Reynolds St
#208
Pontiac, IL 61764
Phone (815) 844-2001
2500 W Reynolds St
Ste 207
Pontiac, IL 61764
Phone (815) 579-9002
2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828
111 Spring St
Fl 4
Streator, IL 61364
Phone (815) 672-4587
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 041-289555 | IL | Yes |
Addresses
Primary practice location
2500 W Reynolds St
Pontiac, IL 61764-9774
Mailing address
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 844-2001
Other providers in Pontiac, IL
- Nabila Ashraf
- Associated Dentists, PC
- Asta Care Center of Pontiac LLC
- Asta Therapy Services LLC
- At Home Counseling, LLC
- Yong Un Baek
- Erin Baker
- Haiven Jo Lei Baker
- Rebecca Ballard
- Brittany Barlow
All providers in Pontiac, IL · Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.