Kendra Poole Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

KENDRA POOLE INC

Practice address

334 Backbone Rd E
Princeton, IL 61356-9685

Phone

(815) 303-4668

Fax

(949) 862-8061

NPI assigned

Nov 4, 2021

Organization subpart

No

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

Authorized official

Name

Kendra Mae Poole, APNNPI 1700480662

Title

FNP/ Owner

Phone

(815) 303-4668

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kendra Mae Poole, APRN FNP-C

  • Family Nurse Practitioner
  • Princeton, IL
  • NPI 1700480662
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1831854744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 STATE ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613543465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 BACKBONE RD E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613569685",
            "telephone_number": "815-303-4668",
            "fax_number": "949-862-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDRA POOLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "FNP/ OWNER",
        "authorized_official_telephone_number": "815-303-4668",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831854744",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Rackley Perry Memorial Hospital
• Julia Rackley Perry Memorial Hospital
• Julia Rackley Perry Memorial Hospital
• Leonard M. Kaczorowski, M.D.
• David Keane Kalapp, D.C.
• Ketan R Patel
• Laura Krabill Kheshgi, D.M.D.
• Tiana Josephine Kilanowski
• Thomas Albert Kovacic
• Kellie Marie Kozlowski, PMHNP-BC

• Family Nurse Practitioner in Princeton, IL
• Providers in Princeton, 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 Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.