Individual provider Active NPI

Kylee Marie Weaver, FNP

  • Family Nurse Practitioner
  • Lewistown, IL
National Provider Identifier
1639962210
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.000000 Issued in IL
Practice address
408 S Main St
Lewistown, IL 61542-1563
Phone
(309) 547-9700
NPI assigned
May 27, 2025
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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 209.000000 IL Primary

Addresses

Primary practice location

408 S Main St
Lewistown, IL 61542-1563

Mailing address

408 S Main St
Lewistown, IL 61542-1563
Phone (309) 547-9700

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
I20260316000614 IL Practitioner - Nurse Practitioner 5395104616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Hospital AssociationGroup PAC ID 2769375021, 124 clinicians

Practice addresses (Care Compare)

408 S Main St
Lewistown, IL 61542-1563
Phone (309) 647-0201

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.000000ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Graham Hospital Association CurrentSince Jan 9, 2026 Accepting new patients
Graham Hospital Association CurrentSince Jan 9, 2026 Accepting new patients

Locations

175 S Main St
Canton, IL 61520
Phone (309) 647-3937

408 S Main St
Lewistown, IL 61542
Phone (309) 547-9700

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

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": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1639962210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 S MAIN ST",
            "city": "LEWISTOWN",
            "state": "IL",
            "postal_code": "615421563",
            "telephone_number": "309-547-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S MAIN ST",
            "city": "LEWISTOWN",
            "state": "IL",
            "postal_code": "615421563",
            "telephone_number": "309-547-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "KYLEE",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewistown, IL

Sources for this page

Verify at the official NPI Registry.