Kacey Caitlyn Zobrist, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.157655 Issued in IL

Practice address

134 W Adams St
Morton, IL 61550-1802

Phone

(217) 528-7541

Fax

(309) 676-6545

NPI assigned

May 25, 2018

Last updated

Aug 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kacey.zobrist.1@28977.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  Medicare reassignment NPD

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1700377603",
    "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": "134 W ADAMS ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501802",
            "telephone_number": "217-528-7541",
            "fax_number": "309-676-6545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-655-2274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZOBRIST",
        "first_name": "KACEY",
        "middle_name": "CAITLYN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.157655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffani L Williams, PA-C
• Theodore Fred Witzig Jr., PH.D.
• Rachel Yang
• Joseph C Zimmerman III, DDS
• Jason H Zobrist, LPC

• Pediatrics Physician in Morton, IL
• Providers in Morton, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.