Individual provider Active NPI

Krista N Ludwig, FNP

  • Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1437523677
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209013618 Issued in IL
Practice address
4500 Memorial Dr
Belleville, IL 62226-5360
Phone
(618) 257-6220
NPI assigned
Nov 28, 2015
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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 209013618 IL Primary
Family Nurse Practitioner 363LF0000X 209013618 IL

Addresses

Primary practice location

4500 Memorial Dr
Belleville, IL 62226-5360

Mailing address

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

Other practice location 1

2 Memorial Dr
Ste 205
Alton, IL 62002-6723
Phone (618) 433-6632

Other identifiers 1

IdentifierTypeStateIssuer
420037882MedicaidMO

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20160203000028 IL Practitioner - Nurse Practitioner 2264736826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 257-6220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209013618ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Nov 1, 2022 Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince May 18, 2020 Accepting new patients
Washington University Physicians in Illinois, Inc Current Accepting new patients
Fairview Heights Medical Group SC CurrentSince Nov 1, 2022 Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince May 18, 2020 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

2 Memorial Dr
Ste 205
Alton, IL 62002
Phone (618) 465-5849

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6481

660 S Euclid Ave
Saint Louis, MO 63110

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1448668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1437523677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-6220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Memorial Dr",
            "address_2": "Ste 205",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620026723",
            "country_code": "US",
            "telephone_number": "618-433-6632",
            "fax_number": "618-212-8591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUDWIG",
        "first_name": "KRISTA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-28",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209013618",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013618",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420037882",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "2 Memorial Dr",
            "address_2": "Ste 205",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4500 Memorial Dr",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.