Kathryn M Endress, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F06141327 Issued in IL

Practice address

1701 W Garden St
Peoria, IL 61605-3531

Phone

(309) 680-7600

Fax

(309) 680-7686

NPI assigned

Aug 27, 2014

Sex

Female

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 2

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

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1487054425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W GARDEN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616053531",
            "telephone_number": "309-680-7600",
            "fax_number": "309-680-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W GARDEN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616053531",
            "telephone_number": "309-680-7600",
            "fax_number": "309-680-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDRESS",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-011751",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "F06141327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "209-011751",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL CONTROLLED SUBSTANCE LICENSE",
            "identifier": "309-007528",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Embry, APN
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• Endocrine & Diabetes, SC
• Michael Endris, M.D.
• Sarah Engberg
• Jessica Engel
• Leah England
• Katy Irene Enloe, P.T.

• Family Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.