NPIMap

Individual provider Active NPI

Angela Brooke Kaylor, NP

  • Primary Care Nurse Practitioner
  • Rosiclare, IL
National Provider Identifier
1770255481
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
209.024116 Issued in IL
Practice address
6 Ferrell Rd
Rosiclare, IL 62982-1052
Phone
(618) 285-6634
NPI assigned
Sep 30, 2021
Last updated
Sep 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 209.024116 IL Primary

Addresses

Primary practice location

6 Ferrell Rd
Rosiclare, IL 62982-1052

Mailing address

165 Lambtown Rd
Cave in Rock, IL 62919-2123
Phone (618) 638-2931

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
I20211105001962 IL Practitioner - Nurse Practitioner 9335538792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hardin County General HospitalGroup PAC ID 2365400272, 9 clinicians

Practice addresses (Care Compare)

6 Ferrell Rd
Rosiclare, IL 62982-1052
Phone 6182856634309

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.024116ILMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hardin County General Hospital CurrentSince Oct 15, 2021 Accepting new patients
Hardin County General Hospital Past Accepting new patients

Locations

6 Ferrell Rd
Rosiclare, IL 62982
Phone (618) 285-6634

Interoperability endpoints

  • Direct secure messaging: akaylor65816@sih.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1770255481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 LAMBTOWN RD",
            "city": "CAVE IN ROCK",
            "state": "IL",
            "postal_code": "629192123",
            "telephone_number": "618-638-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 FERRELL RD",
            "city": "ROSICLARE",
            "state": "IL",
            "postal_code": "629821052",
            "telephone_number": "618-285-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYLOR",
        "first_name": "ANGELA",
        "middle_name": "BROOKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209.024116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosiclare, IL

Sources for this page

Verify at the official NPI Registry.