Individual provider Active NPI

Kathleen Probst, NP

  • Family Nurse Practitioner
  • Chester, IL
National Provider Identifier
1386836328
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209006709 Issued in IL
Practice address
2319 Old Plank Rd
Chester, IL 62233-1153
Phone
(618) 826-2388
Fax
(618) 826-3350
NPI assigned
Aug 14, 2007
Last updated
Dec 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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 143113 MO
Family Nurse Practitioner 363LF0000X 209006709 IL Primary

Addresses

Primary practice location

2319 Old Plank Rd
Chester, IL 62233-1153

Mailing address

4084 Redcastle PL
Swansea, IL 62226-7853
Phone (618) 239-6923

Other identifiers 1

IdentifierTypeStateIssuer
209006709OtherILMEDICAL LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071128000464 IL Practitioner - Nurse Practitioner 5698864684 Reassigns benefits to 1 organization
I20150918001968 MO Practitioner - Nurse Practitioner 5698864684 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Access Urgent Care PCGroup PAC ID 8820171929, 130 clinicians

Practice addresses (Care Compare)

9556 Manchester Rd
Saint Louis, MO 63119-1313
Phone (314) 961-2255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209006709ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy East Ambulatory Services LLC CurrentSince Jun 18, 2018 Accepting new patients
Tauc Il, PC CurrentSince Aug 29, 2024 Accepting new patients
Cep America, LLC Current Accepting new patients
Cep America LLC CurrentSince Jan 1, 2020 Accepting new patients
Cep America LLC CurrentSince Jan 1, 2020 Accepting new patients
Total Access Urgent Care, PC CurrentSince Nov 18, 2020 Accepting new patients
Total Access Urgent Care, PC CurrentSince Nov 18, 2020 Accepting new patients
SSM Health Care St Louis Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

400 Belt Line Rd
Collinsville, IL 62234
Phone (618) 215-5703

404 Belt Line Rd
Collinsville, IL 62234
Phone (618) 215-5703

1103 Central Park Dr
O Fallon, IL 62269
Phone (618) 215-5703

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

11445 Olive Blvd
Saint Louis, MO 63141
Phone (314) 428-9543

9556 Manchester Rd
Saint Louis, MO 63119
Phone (314) 373-5740

1717 Madison Ave
Washington, MO 63090
Phone (636) 244-6950

13861 Manchester Rd
Wildwood, MO 63011
Phone (636) 220-9333

Organizations & group practices 8

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1386836328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4084 REDCASTLE PL",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622267853",
            "telephone_number": "618-239-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 OLD PLANK RD",
            "city": "CHESTER",
            "state": "IL",
            "postal_code": "622331153",
            "telephone_number": "618-826-2388",
            "fax_number": "618-826-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBST",
        "first_name": "KATHLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "143113",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209006709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "209006709",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, IL

Sources for this page

Verify at the official NPI Registry.