Renell Frances Composto

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0209023629 Issued in IL

Practice address

1130 S Veterans Pkwy
Bloomington, IL 61704-7117

Phone

(866) 389-2727

NPI assigned

Oct 11, 2021

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

State licenses

Practice roles

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.

• Bloomington Pediatrics and Allergy LTD

  • Specialist
  • Bloomington, IL
  • NPI 1053506352
  NPD (past)

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1568124154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S VETERANS PKWY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047117",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 S VETERANS PKWY",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047117",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMPOSTO",
        "first_name": "RENELL",
        "middle_name": "FRANCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "0209023629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Leslie Colloton, MD
• Kimberly Colwell
• Carolyn K Company, MA, MSED
• Compass Counselors LTD.
• Compass Counselors LTD.
• Brian Compton, MD
• Violeta Cone
• Connect Wellness PLLC
• Connecting Point Counseling
• Connection Psychiatry, PLLC

• Family Nurse Practitioner in Bloomington, IL
• Providers in Bloomington, 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 Oct 11, 2021; 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.