Individual provider Active NPI

Casey M Kimler, APN

  • Nurse Practitioner
  • Chillicothe, IL
National Provider Identifier
1710396395
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-011689 Issued in IL
Practice address
319 N 4TH St
Chillicothe, IL 61523-2059
Phone
(309) 677-0645
Fax
(309) 683-5928
NPI assigned
Aug 7, 2014
Last updated
Aug 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-011689 IL Primary

Addresses

Primary practice location

319 N 4TH St
Chillicothe, IL 61523-2059

Mailing address

319 N 4TH St
Chillicothe, IL 61523-2059
Phone (309) 677-0645

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
I20140923000649 IL Practitioner - Nurse Practitioner 4082833157

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Community Health ClinicGroup PAC ID 7416850318, shared by 4 NPIs, 50 clinicians

Practice addresses (Care Compare)

1800 N Knoxville Ave
Suite a
Peoria, IL 61603-3005
Phone (309) 680-7600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209-011689ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1710396395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 N 4TH ST",
            "city": "CHILLICOTHE",
            "state": "IL",
            "postal_code": "615232059",
            "telephone_number": "309-677-0645",
            "fax_number": "309-683-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 N 4TH ST",
            "city": "CHILLICOTHE",
            "state": "IL",
            "postal_code": "615232059",
            "telephone_number": "309-677-0645",
            "fax_number": "309-683-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMLER",
        "first_name": "CASEY",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-011689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, IL

Sources for this page

Verify at the official NPI Registry.