Kaitlyn Lee Fields, WHNP-BC
Individual provider Active NPI Women's Health Nurse Practitioner · Havana, IL
NPI 1578382016 · NPPES record last updated Dec 20, 2024
Key facts
- NPI
- 1578382016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Women's Health Nurse Practitioner 363LW0102X
- License
- 209.030703 (IL)
- Practice address
- 615 N Promenade St
Havana, IL 62644-1243 - Phone
- (309) 543-6600
- NPI assigned
- Oct 9, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mason Hospital District
Practice addresses (Care Compare)
1301 S E Ave
Manito, IL 61546-8909
Phone (309) 968-5311
615 N Promenade St
Havana, IL 62644-1243
Phone (309) 543-8510
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250205000298 | IL | Practitioner - Nurse Practitioner | 9537699657 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.030703 | IL | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mason Hospital District | Current |
Accepting new patients | |
| Mason Hospital District | Current | Accepting new patients | |
| Mason Hospital District | Current |
Accepting new patients |
Locations
615 N Promenade St
Havana, IL 62644
Phone (309) 543-8510
122 E Elm St
Mason City, IL 62664
Phone (217) 482-3400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 209.030703 | IL | Yes |
Addresses
Primary practice location
615 N Promenade St
Havana, IL 62644-1243
Mailing address
PO Box 530
Havana, IL 62644-0530
Phone (309) 543-6600
Other providers in Havana, IL
- Renold B Bleem
- Karen Faye Brauer
- Tracey Mae Canete
- Rachel Lynn Davenport
- Dr. Strauman
- Faythe Reyhan Flinn
- Foot and Ankle Associates of Central Illinois LLC
- Yvonne Lynn Fornoff
- Marcie L. Ganson
- Randall Joe Goodman II
All providers in Havana, IL · Women's Health Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.