NPIMap

Individual provider Active NPI

Kelsey Marie Levault, MD

  • Family Medicine Physician
  • Taylorville, IL
National Provider Identifier
1447744438
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125072817 Issued in IL
Practice address
1304 Burnett Dr
Taylorville, IL 62568-9519
Phone
(217) 321-9310
Fax
(217) 692-2422
NPI assigned
Jun 21, 2018
Last updated
Dec 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125072817 IL Primary

Addresses

Primary practice location

1304 Burnett Dr
Taylorville, IL 62568-9519

Mailing address

1304 Burnett Dr
Taylorville, IL 62568-9519
Phone (217) 321-9310

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klevault198724@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210828000181 IL Practitioner - Family Practice 5496003105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1304 W Burnett Dr
Taylorville, IL 62568-9519
Phone (217) 321-9310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Prairie, Inc CurrentSince Sep 7, 2021 Accepting new patients
HSHS Prairie, Inc CurrentSince Sep 7, 2021 Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

1304 Burnett Dr
Taylorville, IL 62568
Phone (217) 321-9310

Interoperability endpoints

  • Direct secure messaging: klevault198724@ewd.direct.hshs.org

Organizations & group practices 2

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 9

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1447744438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 BURNETT DR",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625689519",
            "telephone_number": "217-321-9310",
            "fax_number": "217-692-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 BURNETT DR",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625689519",
            "telephone_number": "217-321-9310",
            "fax_number": "217-692-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVAULT",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125072817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klevault198724@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1304 BURNETT DR",
            "city": "TAYLORVILLE",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625689519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Taylorville, IL

Sources for this page

Verify at the official NPI Registry.