Individual provider Active NPI

Kyle May, APRN, CNP

  • Gerontology Nurse Practitioner
  • Bloomington, IL
National Provider Identifier
1679075022
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
209017287 Issued in IL
Practice address
1505 Eastland Dr Ste 320
Bloomington, IL 61701-7912
Phone
(309) 661-2368
Fax
(309) 662-9709
NPI assigned
Mar 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 209.017287 IL
Gerontology Nurse Practitioner 363LG0600X 209017287 IL Primary

Addresses

Primary practice location

1505 Eastland Dr Ste 320
Bloomington, IL 61701-7912

Mailing address

1505 Eastland Dr Ste 320
Bloomington, IL 61701-7912
Phone (309) 661-2368

Other practice location 1

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 261-0579

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
I20191107000277 IL Practitioner - Nurse Practitioner 1658703970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
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)

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.017287ILMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 28, 2019 Accepting new patients

Locations

1505 Eastland Dr
Ste 320
Bloomington, IL 61701
Phone (309) 661-2368

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1679075022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR STE 320",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017912",
            "telephone_number": "309-661-2368",
            "fax_number": "309-662-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR STE 320",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017912",
            "telephone_number": "309-661-2368",
            "fax_number": "309-662-9709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-261-0579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAY",
        "first_name": "KYLE",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-01",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "IL",
            "license": "209.017287",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209017287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.