Individual provider Active NPI

Marsha R Kirchner, CF-NP

  • Nurse Practitioner
  • Havana, IL
National Provider Identifier
1457544389
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209006708 Issued in IL
Practice address
615 N Promenade St
Havana, IL 62644-1243
Phone
(309) 543-6600
Fax
(309) 543-2089
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209006708 IL Primary

Addresses

Primary practice location

615 N Promenade St
Havana, IL 62644-1243

Mailing address

615 N Promenade St
P O Box 530
Havana, IL 62644-1243
Phone (309) 543-6600

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
I20141020001440 IL Order and Referring Only - Nurse Practitioner 8224122320

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Southern Illinois University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mason Hospital DistrictGroup PAC ID 2466360607, 41 clinicians

Practice addresses (Care Compare)

615 N Promenade St
Havana, IL 62644-1243
Phone (309) 543-8510

Hospital & facility affiliations

  • Mason District Hospital Hospital, Havana, IL, CCN 141313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209006708ILMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: marsha.kirchner@hmamdh.eclinicaldirectplus.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1457544389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N PROMENADE ST",
            "address_2": "P O BOX 530",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626441243",
            "telephone_number": "309-543-6600",
            "fax_number": "309-543-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N PROMENADE ST",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626441243",
            "telephone_number": "309-543-6600",
            "fax_number": "309-543-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCHNER",
        "first_name": "MARSHA",
        "middle_name": "R",
        "credential": "CF-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havana, IL

Sources for this page

Verify at the official NPI Registry.