NPIMap

Individual provider Active NPI

Keri Jane Mullins, APRN-BC

  • Family Nurse Practitioner
  • Oblong, IL
National Provider Identifier
1710143367
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209007177 Issued in IL
Practice address
1366 E 1050TH Ave
Oblong, IL 62449-2409
Phone
(618) 592-3119
Fax
(618) 546-2602
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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 209007177 IL Primary

Addresses

Primary practice location

1366 E 1050TH Ave
Oblong, IL 62449-2409

Mailing address

1366 E 1050TH Ave
Oblong, IL 62449-2409
Phone (618) 592-3119

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address keri.mullins@crawfordmh.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101111000984 IL Practitioner - Nurse Practitioner 5092900340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crawford Hospital DistrictGroup PAC ID 7719898071, 71 clinicians

Practice addresses (Care Compare)

104 N Garfield St
Oblong, IL 62449-1426
Phone (618) 592-3119

1101 N Allen St
CMH Rural Health
Robinson, IL 62454-1168
Phone (618) 544-3699

Hospital & facility affiliations

  • Crawford Memorial Home Health Home health agency, Robinson, IL, CCN 147175
  • Crawford Memorial Hospital Hospital, Robinson, IL, CCN 141343
  • Good Samaritan Hospital Hospital, Vincennes, IN, CCN 150042
  • Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023
  • St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209007177ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford Hospital District CurrentSince Jul 22, 2013 Accepting new patients
Crawford Hospital District CurrentSince Jul 22, 2013 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Crawford Hospital District Past Accepting new patients
RWR Medical Arts SC Past Accepting new patients

Locations

104 N Garfield St
Oblong, IL 62449
Phone (618) 592-3119

1366 E 1050th Ave
Oblong, IL 62449
Phone (618) 592-3119

1002 N Allen St
Ste B
Robinson, IL 62454

1101 N Allen St
Robinson, IL 62454
Phone (618) 544-3125

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

Organizations & group practices 11

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 9

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1710143367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 E 1050TH AVE",
            "city": "OBLONG",
            "state": "IL",
            "postal_code": "624492409",
            "telephone_number": "618-592-3119",
            "fax_number": "618-546-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 E 1050TH AVE",
            "city": "OBLONG",
            "state": "IL",
            "postal_code": "624492409",
            "telephone_number": "618-592-3119",
            "fax_number": "618-546-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "KERI",
        "middle_name": "JANE",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209007177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "keri.mullins@crawfordmh.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1366 E 1050th Ave",
            "city": "Oblong",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624492409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oblong, IL

Sources for this page

Verify at the official NPI Registry.