Individual provider Active NPI

Krysten Rollins, FNP-BC

  • Family Nurse Practitioner
  • Oak Park, IL
National Provider Identifier
1821494154
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.012121 Issued in IL
Practice address
14 Lake St
Oak Park, IL 60302-2606
Phone
(708) 383-0113
NPI assigned
Nov 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 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 209.012121 IL Primary

Addresses

Primary practice location

14 Lake St
Oak Park, IL 60302-2606

Mailing address

14 Lake St
Oak Park, IL 60302-2606
Phone (708) 383-0113

Other names 1

  • Krys Rollins Other name

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
I20150325001088 IL Practitioner - Nurse Practitioner 1254658511 Reassigns benefits to 2 organizations

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
PCC Community Wellness CenterGroup PAC ID 1557270139, 91 clinicians
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

14 Lake St
Oak Park, IL 60302-2606
Phone 7083830113220005

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100

Hospital & facility affiliations

  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.012121ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP CurrentSince Jan 5, 2026 Accepting new patients
PCC Community Wellness Center CurrentSince Jan 28, 2020 Accepting new patients
PCC Community Wellness Center CurrentSince Jan 28, 2020 Accepting new patients
Cepamerica Illinois LLP CurrentSince Jan 5, 2026 Accepting new patients
PCC Community Wellness Center Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

6201 Roosevelt Rd
Berwyn, IL 60402
Phone (708) 386-0845

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

Interoperability endpoints

  • Direct secure messaging: krysten.rollins.1@13158.direct.athenahealth.com

Organizations & group practices 6

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 1

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": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1821494154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022606",
            "telephone_number": "708-383-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022606",
            "telephone_number": "708-383-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLINS",
        "first_name": "KRYSTEN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-13",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.012121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYS",
            "last_name": "ROLLINS",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.