Kelly J Hines, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277002808 Issued in IL

Practice address

21039 Tail Feathers Dr
Mokena, IL 60448-2443

Phone

(773) 595-6515

NPI assigned

May 2, 2014

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kelly.hines.p1@direct.alegiscare.nextgenshare.com
• Direct secure messaging: kelly.hines.1@28492.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.

• Vpa PC

  • Family Medicine Physician
  • Oakbrook Terrace, IL
  • NPI 1174925663
  Medicare reassignment NPD
• Assured Choice Health Care LLC

  • Home Health Agency
  • Mokena, IL
  • NPI 1609523836
  NPD Authorized official
• Assured Choice Home Health LLC

  • Home Health Agency
  • Mokena, IL
  • NPI 1902189731
  NPD Authorized official
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1508276205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21039 TAIL FEATHERS DR",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482443",
            "telephone_number": "773-595-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21039 TAIL FEATHERS DR",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482443",
            "telephone_number": "773-595-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-02",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277002808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Henrichs, LCPC
• Highland Park CVS, L.L.C.
• Highland Park CVS, L.L.C.
• Hill-Rom Company, Inc.
• Paula K. Hinds, OTR
• Raymond E Hines III, PA-C
• Loai Hishmeh
• Hmi Foot and Ankle Group, SC
• Alexandra Hoffman
• Lauren Hogue, OTD, OTR/L

• Family Nurse Practitioner in Mokena, IL
• Providers in Mokena, 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 May 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.