Individual provider Active NPI

Kaitlin Samantha Brown, PA-C

  • Physician Assistant
  • Springfield, IL
National Provider Identifier
1548974686
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.009332 Issued in IL
Practice address
1301 S Koke Mill Rd
Springfield, IL 62711-9252
Phone
(217) 547-9100
Fax
(217) 547-9236
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.009332 IL Primary

Addresses

Primary practice location

1301 S Koke Mill Rd
Springfield, IL 62711-9252

Mailing address

1301 S Koke Mill Rd
Springfield, IL 62711-9252
Phone (217) 547-9100

Other practice location 1

800 E Carpenter St
Springfield, IL 62769-1000
Phone (217) 544-6464

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
I20230301002697 IL Practitioner - Physician Assistant 6901279504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Center of IlGroup PAC ID 0143299628, 29 clinicians
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

1301 S Koke Mill Rd
Springfield, IL 62711-9252
Phone (217) 547-9100

775 Engineering Ave
Springfield, IL 62703-5909
Phone (217) 522-4300

800 E Carpenter St
Springfield, IL 62702-5324
Phone (217) 544-6464

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.009332ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic, LLP CurrentSince Mar 6, 2023 Accepting new patients
Orthopaedic Center of Il CurrentSince Oct 6, 2025 Accepting new patients
Orthopaedic Center of Illinois Past Accepting new patients

Locations

1750 E Lake Shore Dr
Ste 200
Decatur, IL 62521
Phone (217) 422-2500

800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

1301 S Koke Mill Rd
Springfield, IL 62711
Phone (217) 547-9100

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

Interoperability endpoints

  • Direct secure messaging: kaitlinbrown@oci.allscriptsdirect.net
  • Direct secure messaging: kaitlin.brown.1@28977.direct.athenahealth.com

Organizations & group practices 3

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.

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": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1548974686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S KOKE MILL RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627119252",
            "telephone_number": "217-547-9100",
            "fax_number": "217-547-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S KOKE MILL RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627119252",
            "telephone_number": "217-547-9100",
            "fax_number": "217-547-9236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E Carpenter St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627691000",
            "country_code": "US",
            "telephone_number": "217-544-6464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KAITLIN",
        "middle_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.