Kim Mank, ACNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209007723 Issued in IL

Practice address

4600 Memorial Dr Ste 200
Belleville, IL 62226-5363

Phone

(618) 233-2220

NPI assigned

Nov 9, 2009

Last updated

Sep 29, 2026By 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 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cep America - Illinois Hospitalists, LLP

  • Internal Medicine Physician
  • Alton, IL
  • NPI 1164973947
  NPD
• Cep America-Illinois Hospitalists

  • Hospitalist Physician
  • Bloomington, IL
  • NPI 1669276523
  NPD
• Cep America-Illinois Hospitalists, LLP

  • Internal Medicine Physician
  • Belleville, IL
  • NPI 1841613403
  NPD
• Fairview Heights Medical Group SC

  dba BJC Medical Group of Illinois

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1073022000
  NPD
• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668
  NPD
• Healthcare Physicians of Southern Illinois, PC

  • Family Medicine Physician
  • Belleville, IL
  • NPI 1023034618
  NPD (past)
• HSHS Prairie, Inc

  dba HSHS Prairie Foot and Ankle - Jacksonville

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, IL
  • NPI 1629465414
  NPD (past)
• PC Associates LLC

  • Internal Medicine Physician
  • O'Fallon, IL
  • NPI 1235452855
  NPD (past)

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1639406879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DR STE 200",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265363",
            "telephone_number": "618-233-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MEMORIAL DR STE 200",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265363",
            "telephone_number": "618-233-2220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12860 Troxler Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "IL",
            "postal_code": "622492898",
            "country_code": "US",
            "telephone_number": "618-651-2816",
            "fax_number": "618-654-1703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANK",
        "first_name": "KIM",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-09",
        "last_updated": "2026-09-29",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209007723",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.007723",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209007723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4600 Memorial Dr Ste 200",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hatim A Mahmood, M.D.
• Julie Malherek, PT
• Nitin Gulshan Malhotra, MD
• Jordan Danielle Malm, LPC, PLPC
• Mary E Maloney, ANP
• Ariel Michelle Mann, LCSW
• Eric S Mann, MD, PHD
• Salma Mannan-Hilaly, MD
• Deborah Mansfield, PT
• Lindsay Merle Mansfield, M.S. CCC-SLP

• Adult Health Nurse Practitioner in Belleville, IL
• Providers in Belleville, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.