Knichole Leanne Tripp, APRN, FNP-BC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2023004504 Issued in IL

Practice address

211 N Broadway
Goreville, IL 62939-2323

Phone

(618) 995-1002

NPI assigned

Mar 31, 2023

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

Other names 1

• Knichole Leanne Tripp Professional name

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: knichole.tripp.1@7601.direct.athenahealth.com

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.

• Rural Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Anna, IL
  • NPI 1982666384
  Medicare reassignment NPD
• Rural Health, Inc.

  • Community/Retail Pharmacy
  • Anna, IL
  • NPI 1801634183
  NPD
• Rural Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Vienna, IL
  • NPI 1932263332
  NPD (past)

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1487359394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 WEBB TOWN RD",
            "city": "TUNNEL HILL",
            "state": "IL",
            "postal_code": "629723016",
            "telephone_number": "618-771-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N BROADWAY",
            "city": "GOREVILLE",
            "state": "IL",
            "postal_code": "629392323",
            "telephone_number": "618-995-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Metropolis",
            "state": "IL",
            "postal_code": "629602311",
            "country_code": "US",
            "telephone_number": "618-524-7499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Webb Town Rd",
            "address_purpose": "LOCATION",
            "city": "Tunnel Hill",
            "state": "IL",
            "postal_code": "629723016",
            "country_code": "US",
            "telephone_number": "618-771-6178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRIPP",
        "first_name": "KNICHOLE",
        "middle_name": "LEANNE",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "2023004504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KNICHOLE",
            "last_name": "TRIPP",
            "middle_name": "LEANNE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Pamela D Pulley, RDH
• Rural Health, Inc.
• Rural Health, Inc.
• Michele Russell
• Daniel Andrew Selock, MS/CADC/LCPC
• Janet S White, PA C

• General Practice Physician in Goreville, IL
• Providers in Goreville, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.