Individual provider Active NPI

Amanda Kierbs, NP

  • Adult Health Nurse Practitioner
  • Urbana, IL
National Provider Identifier
1407397284
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209015741 Issued in IL
Practice address
611 W Park St
Urbana, IL 61801-2501
Phone
(217) 383-3440
NPI assigned
Mar 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.015741 IL
Family Nurse Practitioner 363LF0000X 209015741 IL
Adult Health Nurse Practitioner 363LA2200X 209015741 IL Primary

Addresses

Primary practice location

611 W Park St
Urbana, IL 61801-2501

Mailing address

611 W. Park St
Fapc
Urbana, IL 61801

Other practice location 1

304 W Hay St
Ste 214
Decatur, IL 62526-6328
Phone (217) 872-5943

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
I20170511001062 IL Practitioner - Nurse Practitioner 1153608567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

516 W Madison St
Danville, IL 61832-5657

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.015741ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Neurological Associates LTD. CurrentSince Apr 8, 2017 Accepting new patients
Carle Health Care Incorporated CurrentSince Sep 18, 2023 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

1750 E Lake Shore Dr
Ste 310
Decatur, IL 62521
Phone (217) 464-1220

304 W Hay St
Ste 214
Decatur, IL 62526
Phone (217) 788-3948

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 4

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 2

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": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1407397284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501",
            "telephone_number": "217-383-3440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 W Hay St",
            "address_2": "Ste 214",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625266328",
            "country_code": "US",
            "telephone_number": "217-872-5943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIERBS",
        "first_name": "AMANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.015741",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015741",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209015741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.