Individual provider Active NPI

Colleen Kirr, APN

  • Pediatric Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1699178228
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209011859 Issued in IL
Practice address
2200 Wabash Ave
Springfield, IL 62704-5352
Phone
(217) 528-7541
Fax
(217) 787-1377
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041376881 IL
Pediatric Nurse Practitioner 363LP0200X 209011859 IL Primary

Addresses

Primary practice location

2200 Wabash Ave
Springfield, IL 62704-5352

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Other practice location 1

1331 W 75th Street
Suite 300
Naperville, IL 60540
Phone (630) 355-0003

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
I20211026001166 IL Practitioner - Nurse Practitioner 1052709920 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041376881ILMDRegistered Nurse
209011859ILMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jul 23, 2021 Accepting new patients
Board of Trustees of the University of Illinois CurrentSince Jul 23, 2021 Accepting new patients
Springfield Clinic, LLP CurrentSince Mar 6, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Abc Pediatrics, LTD. Past Accepting new patients

Locations

7694 Solutions Ctr
Chicago, IL 60677

1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000

3501 Old Jacksonville Rd
Springfield, IL 62711
Phone (217) 960-8193

2200 Wabash Ave
Springfield, IL 62704

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

Interoperability endpoints

  • Direct secure messaging: colleen.kirr.1@28977.direct.athenahealth.com

Organizations & group practices 5

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": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1699178228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WABASH AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045352",
            "telephone_number": "217-528-7541",
            "fax_number": "217-787-1377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 W 75th Street",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "60540",
            "country_code": "US",
            "telephone_number": "630-355-0003",
            "fax_number": "630-355-9822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRR",
        "first_name": "COLLEEN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041376881",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209011859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.