Individual provider Active NPI

Katy Jo Northcutt, APRN, CNP

  • Family Nurse Practitioner
  • Bloomington, IL
National Provider Identifier
1609343128
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018225 Issued in IL
Practice address
9 Heartland Dr Ste C
Bloomington, IL 61704-7733
Phone
(309) 663-7642
Fax
(309) 663-8359
NPI assigned
Nov 2, 2018
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209018225 IL Primary

Addresses

Primary practice location

9 Heartland Dr Ste C
Bloomington, IL 61704-7733

Mailing address

611 W Park St
Urbana, IL 61801-2501
Phone (217) 383-3311

Other practice location 1

1523 Lafayette Park Dr Unit 6
Bloomington, IL 61701-6800
Phone (217) 365-7928

Other practice location 2

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

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
I20200629001040 IL Practitioner - Nurse Practitioner 1355763939 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, shared by 8 NPIs, 387 clinicians

Practice addresses (Care Compare)

1120 E War Memorial Dr
Peoria, IL 61616-7757
Phone (309) 685-4411

3591 Griffin Ave
Pekin, IL 61554-6258
Phone (309) 353-6301

3915 Barring Trce
Peoria, IL 61615-2500
Phone (309) 689-6280

5401 N Knoxville Ave
Peoria, IL 61614-5021

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

8914 N Knoxville Ave
Peoria, IL 61615-1410
Phone (309) 691-9110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209018225ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Current Accepting new patients
Abraham Lincoln Memorial Hospital CurrentSince Dec 28, 2025 Accepting new patients
Carle Health Medical Group CurrentSince Sep 11, 2025 Accepting new patients
Methodist Medical Center of Illinois Family CurrentSince Oct 1, 2025 Accepting new patients
Passavant Memorial Area Hospital Association Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Oct 1, 2025 Accepting new patients
Passavant Memorial Area Hospital Association Current Accepting new patients
Midwest Emergency Department Specialists LTD CurrentSince Apr 1, 2021 Accepting new patients
Abraham Lincoln Memorial Hospital CurrentSince Apr 1, 2025 Accepting new patients
Proctor Health Systems CurrentSince Mar 1, 2023 Accepting new patients
Carle West Physician Group Inc CurrentSince Sep 29, 2025 Accepting new patients
Abraham Lincoln Memorial Hospital CurrentSince Apr 1, 2025 Accepting new patients
Bloomington Primary Care, LTD. CurrentSince Mar 4, 2024 Accepting new patients
Proctor Health Systems CurrentSince Mar 1, 2023 Accepting new patients
Passavant Memorial Area Hospital Association Current Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

9 Heartland Dr
Ste C
Bloomington, IL 61704
Phone (309) 663-7642

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

200 Stahlhut Dr
Lincoln, IL 62656
Phone (217) 605-5611

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 671-7779

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

8914 N Knoxville Ave
Peoria, IL 61615
Phone (309) 691-9110

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

209 N Cummings Ln
Washington, IL 61571
Phone (309) 643-6185

Interoperability endpoints

  • Direct secure messaging: knorthcuttaprn388469@carlehiedirect.net

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 1

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": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1609343128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501",
            "telephone_number": "217-383-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HEARTLAND DR STE C",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047733",
            "telephone_number": "309-663-7642",
            "fax_number": "309-663-8359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1523 Lafayette Park Dr Unit 6",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617016800",
            "country_code": "US",
            "telephone_number": "217-365-7928",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 N Edward St",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625264163",
            "country_code": "US",
            "telephone_number": "217-876-8121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORTHCUTT",
        "first_name": "KATY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.