Individual provider Active NPI

Kyle McClintock

  • Hearing Instrument Specialist
  • Peoria, IL
National Provider Identifier
1679000772
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
037-3028 Issued in IL
Practice address
7800 N Sommer St Ste 305
Peoria, IL 61615-1994
Phone
(309) 685-0887
Fax
(309) 685-0887
NPI assigned
May 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 037-3028 IL Primary

Addresses

Primary practice location

7800 N Sommer St Ste 305
Peoria, IL 61615-1994

Mailing address

7800 N Sommer St Ste 305
Peoria, IL 61615-1994
Phone (309) 685-0887

Other practice location 1

3801 Ge Rd Ste 1
Bloomington, IL 61704-4193
Phone (309) 662-9552

Other practice location 2

531 Tenney St
Kewanee, IL 61443-3746
Phone (309) 853-9816

Other practice location 3

261 N Broad St Ste 57
Galesburg, IL 61401-4556
Phone (309) 342-5166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
037-3028ILMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Midstate Hearing Inc. Hearing Instrument Specialist Current Accepting new patients
Hearing Care Professionals LLC Hearing Instrument Specialist Past Accepting new patients
Hearing Doctors of Illinois, Inc. Past Accepting new patients

Locations

261 N Broad St
Ste 57
Galesburg, IL 61401
Phone (309) 342-5166

531 Tenney St
Kewanee, IL 61443
Phone (309) 853-9816

7800 N Sommer St
Ste 305
Peoria, IL 61615
Phone (309) 685-0887

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1679000772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 N SOMMER ST STE 305",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151994",
            "telephone_number": "309-685-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 N SOMMER ST STE 305",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151994",
            "telephone_number": "309-685-0887",
            "fax_number": "309-685-0887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Ge Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617044193",
            "country_code": "US",
            "telephone_number": "309-662-9552",
            "fax_number": "309-662-9552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "531 Tenney St",
            "address_purpose": "LOCATION",
            "city": "Kewanee",
            "state": "IL",
            "postal_code": "614433746",
            "country_code": "US",
            "telephone_number": "309-853-9816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "261 N Broad St Ste 57",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "IL",
            "postal_code": "614014556",
            "country_code": "US",
            "telephone_number": "309-342-5166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLINTOCK",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-19",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "037-3028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.