Candace Crystal Kudla, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

209023553 Issued in IL

Practice address

1506 W Reynolds St
Pontiac, IL 61764-9674

Phone

(815) 844-6123

Fax

(815) 844-3897

NPI assigned

Sep 8, 2021

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

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint James HospitalGroup PAC ID 0648187252, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Home Health-Eastern Region Home health agency, Bloomington, IL, CCN 147451
• Saint James Hospital Hospital, Pontiac, IL, CCN 140161
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Saint James Hospital

  • Anesthesiology Physician
  • Pontiac, IL
  • NPI 1790735421
  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1154908929
  NPD
• Saint James Hospital

  • Rural Health Clinic/Center
  • Roanoke, IL
  • NPI 1164138848
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Cardinal Medical Group, LTD.

  • Multi-Specialty Clinic/Center
  • Peoria, IL
  • NPI 1992829485
  NPD (past)
• Gibson Community Hospital Association

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

  • Rural Health Clinic/Center
  • Cullom, IL
  • NPI 1790712701
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ottawa Regional Hospital & Healthcare Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• Saint James Hospital

  • General Acute Care Hospital
  • Pontiac, IL
  • NPI 1407808090
  Care Compare affiliation
• St Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  Care Compare affiliation
• St Joseph Medical Center

  • Home Health Agency
  • Bloomington, IL
  • NPI 1851330203
  Care Compare affiliation

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1447929914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S REDBUD LN",
            "city": "FLANAGAN",
            "state": "IL",
            "postal_code": "617409111",
            "telephone_number": "815-257-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649674",
            "telephone_number": "815-844-6123",
            "fax_number": "815-844-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDLA",
        "first_name": "CANDACE",
        "middle_name": "CRYSTAL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209023553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya M Knauff, PT
• Kendel S Knudson, OTD, OTR/L
• Mary Krall
• Samantha Kray, PSYD
• Lindsey Krzyzek, MHP
• Jeffrey Kuska
• Jayme Kwak, M.D.
• Thomas L Ladeairous, PHYSICAL THERAPIST
• Hematheja Lanka, DO
• Caeley Frances Larson, DPT

• Primary Care Nurse Practitioner in Pontiac, IL
• Providers in Pontiac, IL by specialty
• Primary Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.
• 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.