NPIMap

Organization Active NPI

Mindplexity Psychiatric Services, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1437808433
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDPLEXITY PSYCHIATRIC SERVICES, PLLC
Practice address
555 S Perryville Rd Ste 130
Rockford, IL 61108-2527
Phone
(815) 995-2201
NPI assigned
Mar 18, 2022
Last updated
Jun 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Jennie Krull, APRNNPI 1518322510
Title
Medical Director
Phone
(224) 465-4309

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

555 S Perryville Rd Ste 130
Rockford, IL 61108-2527

Mailing address

555 S Perryville Rd Ste 130
Rockford, IL 61108-2527
Phone (815) 995-2201

Other practice location 1

546 E Grant Hwy
Marengo, IL 60152-3346
Phone (815) 995-2201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220518001174 IL Part B Supplier - Clinic/Group Practice 9032596788 Receives reassigned benefits from 8 practitioners
Practice locations: Marengo, IL; Rockford, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2341150Mindplexity Psychiatric Services555 S Perryville Rd - Suite 130, Rockford, IL 61108Certificate of waiverMar 26, 2028

National Provider Directory

National Provider Directory

Locations

265 Stonegate Rd
#102
Algonquin, IL 60102
Phone (224) 678-9180

555 S Perryville Rd
Ste 130
Rockford, IL 61108
Phone (815) 396-8617

1050 Country Club Rd
Unit 386
Woodstock, IL 60098

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1437808433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S PERRYVILLE RD STE 130",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082527",
            "telephone_number": "815-995-2201",
            "fax_number": "224-999-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S PERRYVILLE RD STE 130",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082527",
            "telephone_number": "815-995-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "546 E Grant Hwy",
            "address_purpose": "LOCATION",
            "city": "Marengo",
            "state": "IL",
            "postal_code": "601523346",
            "country_code": "US",
            "telephone_number": "815-995-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDPLEXITY PSYCHIATRIC SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "KRULL",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "224-465-4309",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.