Kevin M. Krippner, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071004205 Issued in IL

Practice address

403 W Virginia Ave
Normal, IL 61761-3666

Phone

(309) 268-5547

Fax

(309) 268-2913

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Bromenn Physicians Management Corporation

  • Family Medicine Physician
  • Normal, IL
  • NPI 1285903799
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1477576114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W VIRGINIA AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613666",
            "telephone_number": "309-268-5547",
            "fax_number": "309-268-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W VIRGINIA AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613666",
            "telephone_number": "309-268-5547",
            "fax_number": "309-268-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIPPNER",
        "first_name": "KEVIN",
        "middle_name": "M.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "071004205",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071004205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05732028",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridget Kos
• Christine Kosharek
• Philip Koszyk, MD
• Meghan Krasny
• Harrison Krebs, MSN, RN, CCRN
• Kroger Limited Partnership I
• Laurie Krolikowski, LCSW
• Piotr Pawel Krolikowski, MD
• Shirley Kroll, RN
• Michelle Caroline Kronmiller, FNP

• Clinical Psychologist in Normal, IL
• Providers in Normal, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.