Karie Lynn Prokop, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.003995 Issued in IL

Practice address

105 S First St
Wilmington, IL 60481-8973

Phone

(815) 476-5210

Fax

(815) 476-4193

NPI assigned

Mar 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kprokop7679@direct.riversidehealthcare.net

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.

• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  Medicare reassignment
• Yazen Joudeh MD LTD

  • Internal Medicine Physician
  • Orland Park, IL
  • NPI 1669734802
  Medicare reassignment
• Riverside Health System

  • Psychiatry Physician
  • Kankakee, IL
  • NPI 1336354430
  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1447558127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S FIRST ST",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604818973",
            "telephone_number": "815-476-5210",
            "fax_number": "815-476-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S FIRST ST",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604818973",
            "telephone_number": "815-476-5210",
            "fax_number": "815-476-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOP",
        "first_name": "KARIE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-04",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.003995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085.003995",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kprokop7679@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "endpointDescription": "Direct, Secure address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "105 S First St",
            "city": "Wilmington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604818973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin Malinowski
• Julie Mitchell
• Gina Marie Morgan, PHARMD
• Hope O'Keefe, APN-C
• Joan Papes, PT
• Angie Marie Rink
• Nancy Slone Rivera, NP
• Madison Paige Segrist, ATS
• Heather Skupien, OTR/L
• Garrett Barton Smith, DDS

• Physician Assistant in Wilmington, IL
• Providers in Wilmington, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.