Kimberley Denise Criss, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209006842 Issued in IL

Practice address

5031 N Illinois St
Fairview Heights, IL 62208-3453

Phone

(618) 212-6800

NPI assigned

Jul 6, 2011

Last updated

Jan 18, 2012By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Illinois Regional Wellness Center

  • Federally Qualified Health Center (FQHC)
  • East Saint Louis, IL
  • NPI 1336258540
  NPD (past)

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1578850905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KASKASKIA ST",
            "city": "MENARD",
            "state": "IL",
            "postal_code": "622591000",
            "telephone_number": "618-826-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5031 N ILLINOIS ST",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083453",
            "telephone_number": "618-212-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISS",
        "first_name": "KIMBERLEY",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209006842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Cremeens
• CD Cremeens
• Ashley R Criley, RBT
• Michele Crisler, OT
• Erica P Criss, APN
• William Austin Critchlow, MD
• Temarra Kimberly Crow
• D & D Services, Inc. (Aveanna Healthcare - IL)
• Rashid Ahmed Dalal, MD
• Kisha R Davis

• Family Nurse Practitioner in Fairview Heights, IL
• Providers in Fairview Heights, 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 Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.