Individual provider Active NPI

Kelli L Harkey, NP-C

  • Nurse Practitioner
  • Winfield, IL
National Provider Identifier
1396283495
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209020754 Issued in IL
Practice address
27W350 High Lake Rd
Winfield, IL 60190-1262
Phone
(630) 933-4000
Fax
(630) 933-1933
NPI assigned
Feb 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209020754 IL Primary

Addresses

Primary practice location

27W350 High Lake Rd
Winfield, IL 60190-1262

Mailing address

27W350 High Lake Rd
Winfield, IL 60190-1262
Phone (630) 933-4000

Other identifiers 2

IdentifierTypeStateIssuer
20807OtherSCSC BOARD OF NURSING
5009278OtherNCNORTH CAROLINA BOARD OF NURSING/MEDICAL BOARD

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
I20200331001402 IL Practitioner - Nurse Practitioner 1658640727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

27 W350 High Lake Rd
Winfield, IL 60190-9998

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20807NCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Apr 8, 2020 Accepting new patients
Central Dupage Physician Group CurrentSince Apr 8, 2020 Accepting new patients
Beyer Chiropractic Center P.C. CurrentSince Jun 17, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

10012 W 190th Pl
Mokena, IL 60448
Phone (708) 478-0300

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

27W350 High Lake Rd
Winfield, IL 60190
Phone (630) 933-4000

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1396283495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27W350 HIGH LAKE RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901262",
            "telephone_number": "630-933-4000",
            "fax_number": "630-933-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27W350 HIGH LAKE RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901262",
            "telephone_number": "630-933-4000",
            "fax_number": "630-933-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKEY",
        "first_name": "KELLI",
        "middle_name": "L",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209020754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC BOARD OF NURSING",
            "identifier": "20807",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF NURSING/MEDICAL BOARD",
            "identifier": "5009278",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.