Individual provider Active NPI

Kayla A Simons, NP

  • Family Nurse Practitioner
  • Ottawa, IL
National Provider Identifier
1659620342
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209009750 Issued in IL
Practice address
1614 E Norris Dr
Ottawa, IL 61350-3681
Phone
(815) 433-1010
Fax
(815) 433-0067
NPI assigned
Sep 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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 209009750 IL Primary

Addresses

Primary practice location

1614 E Norris Dr
Ottawa, IL 61350-3681

Mailing address

1614 E Norris Dr
Ottawa, IL 61350-3681
Phone (815) 433-1010

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
I20130404000232 IL Practitioner - Nurse Practitioner 3678718145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

111 Spring St
Streator, IL 61364-3332
Phone (815) 673-2311

1614 E Norris Dr
OBGYN and Anti Coag
Ottawa, IL 61350-3681
Phone (815) 431-0435

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

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": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1659620342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503681",
            "telephone_number": "815-433-1010",
            "fax_number": "815-433-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503681",
            "telephone_number": "815-433-1010",
            "fax_number": "815-433-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "KAYLA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

Verify at the official NPI Registry.