Individual provider Active NPI

Angela Kay Kern

  • Family Nurse Practitioner
  • Freeburg, IL
National Provider Identifier
1619537867
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209019000 Issued in IL
Practice address
251 Marketplace Dr
Freeburg, IL 62243
Phone
(618) 539-0067
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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 209019000 IL Primary

Addresses

Primary practice location

251 Marketplace Dr
Freeburg, IL 62243

Mailing address

251 Marketplace Dr
Freeburg, IL 62243-4082
Phone (618) 539-0067

Other practice location 1

325 Spring St
Red Bud, IL 62278-1105
Phone (618) 282-7373

Other practice location 2

251 Marketplace Dr
Freeburg, IL 62243
Phone (618) 539-0067

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
I20191227001054 IL Practitioner - Nurse Practitioner 8325472384 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lincoln Surgical Associates, LTD.Group PAC ID 9335320597, 25 clinicians

Practice addresses (Care Compare)

1414 Cross St
Shiloh, IL 62269-2941
Phone (618) 277-7400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Surgical Associates, LTD. CurrentSince Jan 1, 2025 Accepting new patients

Locations

251 Marketplace Dr
#1
Freeburg, IL 62243
Phone (618) 539-0067

251 Marketplace Dr
Freeburg, IL 62243
Phone (618) 539-0067

739 N Jefferson St
#200
Mascoutah, IL 62258
Phone (618) 566-8810

1414 Cross St
Ste 330
Shiloh, IL 62269
Phone (618) 228-8610

Organizations & group practices 2

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 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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1619537867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 MARKETPLACE DR",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "622434082",
            "telephone_number": "618-539-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 MARKETPLACE DR",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "62243",
            "telephone_number": "618-539-0067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Spring St",
            "address_purpose": "LOCATION",
            "city": "Red Bud",
            "state": "IL",
            "postal_code": "622781105",
            "country_code": "US",
            "telephone_number": "618-282-7373",
            "fax_number": "618-282-4190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 Marketplace Dr",
            "address_purpose": "LOCATION",
            "city": "Freeburg",
            "state": "IL",
            "postal_code": "62243",
            "country_code": "US",
            "telephone_number": "618-539-0067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERN",
        "first_name": "ANGELA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeburg, IL

Sources for this page

Verify at the official NPI Registry.