Individual provider Active NPI

Kelsey R Montana, APRN

  • Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1538750690
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209022554 Issued in IL
Practice address
2902 McFarland Rd Ste 300
Rockford, IL 61107-6801
Phone
(815) 316-2100
Fax
(815) 316-2099
NPI assigned
Feb 1, 2021
Last updated
Apr 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.022554 IL
Nurse Practitioner 363L00000X 209022554 IL Primary

Addresses

Primary practice location

2902 McFarland Rd Ste 300
Rockford, IL 61107-6801

Mailing address

PO Box 735263
Chicago, IL 60673-5263

Other names 1

  • Kelsey R Primrose Former name

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
I20210313000069 IL Practitioner - Nurse Practitioner 8820404015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

2902 McFarland Rd
Suite 300
Rockford, IL 61107-6801
Phone (815) 398-9491

770 Beloit Rd
Belvidere, IL 61008-1745
Phone (815) 398-9491

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.02 of 100Reported as group
Quality
68.63
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209022554ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince May 10, 2023 Accepting new patients
Orthomidwest, PLLC CurrentSince May 10, 2023 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

2902 McFarland Rd
Ste 300
Rockford, IL 61107
Phone (815) 316-2100

324 Roxbury Rd
Rockford, IL 61107
Phone (815) 381-7339

535 Roxbury Rd
Rockford, IL 61107
Phone (815) 387-1717

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1538750690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735263",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 MCFARLAND RD STE 300",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076801",
            "telephone_number": "815-316-2100",
            "fax_number": "815-316-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANA",
        "first_name": "KELSEY",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.022554",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "PRIMROSE",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.