Kenneth Guillotte, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

125069953 Issued in IL

Practice address

701 N 1St St Ste D220
Springfield, IL 62702-3757

Phone

(217) 545-3518

Fax

(217) 545-2711

NPI assigned

Jun 5, 2017

Sex

Male

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Emergency Department Specialists LTD 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Abraham Lincoln Memorial Hospital Hospital, Lincoln, IL, CCN 141322
• Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
• Memorial Medical Center Hospital, Springfield, IL, CCN 140148
• Jacksonville Memorial Hospital Hospital, Jacksonville, IL, CCN 141352

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Midwest Emergency Department Specialists LTD

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1245263367

  Emergency Medicine, IL

  Medicare reassignment Care Compare group NPD
• Abraham Lincoln Memorial Hospital

  • Critical Access Hospital
  • Lincoln, IL
  • NPI 1154329753

  IL

  Medicare reassignment NPD
• Abraham Lincoln Memorial Hospital

  • Certified Registered Nurse Anesthetist
  • Lincoln, IL
  • NPI 1558586180

  IL

  Medicare reassignment NPD
• Passavant Memorial Area Hospital Association

  • Critical Access Hospital
  • Jacksonville, IL
  • NPI 1174580831

  IL

  Medicare reassignment NPD
• Passavant Memorial Area Hospital Association

  • Internal Medicine Physician
  • Jacksonville, IL
  • NPI 1760994040

  Family Medicine, IL

  Medicare reassignment NPD
• Abraham Lincoln Memorial Hospital

  • Critical Access Hospital
  • Lincoln, IL
  • NPI 1255304721
  NPD
• Passavant Memorial Area Hospital Association

  • Multi-Specialty Clinic/Center
  • Jacksonville, IL
  • NPI 1235864810
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Abraham Lincoln Memorial Hospital

  • Critical Access Hospital
  • Lincoln, IL
  • NPI 1154329753

  Hospital

  Care Compare affiliation
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1548357973

  Hospital

  Care Compare affiliation
• Memorial Medical Center

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1255317590

  Hospital

  Care Compare affiliation
• Passavant Memorial Area Hospital Association

  • Critical Access Hospital
  • Jacksonville, IL
  • NPI 1174580831

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1649709668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627819679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST STE D220",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023757",
            "telephone_number": "217-545-3518",
            "fax_number": "217-545-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLOTTE",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125069953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Gryczewski, PA-C
• Danielle L Guadarrama, L.M.T, CMLDT
• Andrew K. Guardia, PA
• Paul Hyatt Guerin, DO
• Quentin Guillory, MD
• Molly Guithues, O.D.
• Gary Gummerman
• Donald G Gumprecht, M.D.
• Arun Gunda, M.D.
• Imani Gunnigan

• All providers in Springfield, IL
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.