Kimani Fitzgerald

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.029516 Issued in IL

Practice address

1000 Centennial Dr
East Peoria, IL 61611-4916

Phone

(309) 324-0880

NPI assigned

Aug 8, 2024

Last updated

Aug 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kfitzgeraldaprn451229@carlehiedirect.net

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.

• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Proctor Health Systems

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1134173917
  Medicare reassignment Care Compare group NPD
• Empowerme Medical Group, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Bloomington, IL
  • NPI 1073217204
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  dba Methodist Medical Group

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755

  Family

  NPD
• Proctor Health Systems

  dba Carle Health Princeville

  • Rural Health Clinic/Center
  • Princeville, IL
  • NPI 1356057301
  NPD
• Proctor Health Systems

  dba Proctor Medical Group Surgery - C K Song MD

  • Ambulatory Surgical Clinic/Center
  • Peoria, IL
  • NPI 1720223837
  NPD
• Empowerme Medical Group, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Raleigh, NC
  • NPI 1407673965
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  Care Compare affiliation

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1740011154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6224 N TALISMAN TER",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152749",
            "telephone_number": "309-231-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CENTENNIAL DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616114916",
            "telephone_number": "309-324-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "KIMANI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.029516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Christine Fancher, CCC-SLP
• Julie Ann Feeny, PT
• Elyse Nicole Feinhals, CCLS
• Megan Fischer
• Anna Lisa Fisher, R.PH.
• Delanie Lynn Fletcher, APRN
• Fondulac Rehabilitation & Health Care Center LLC
• Jennifer Anne Forck
• Fresenius Medical Care East Peoria Home, LLC (Fresenius Kidney Care East Peoria Home)
• Dax Fuiten, PHARM.D

• Family Nurse Practitioner in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.