NPIMap

Individual provider Active NPI

Kalinda Jo Shaw

  • Nurse Practitioner
  • Marion, IL
National Provider Identifier
1851961635
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209023069 Issued in IL
Practice address
3411 Professional Park Dr
Marion, IL 62959-6394
Phone
(618) 969-8630
NPI assigned
Jun 25, 2021
Last updated
Mar 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209023069 IL Primary
Family Nurse Practitioner 363LF0000X 209023069 IL
Registered Nurse 163W00000X 041444043 IL

Addresses

Primary practice location

3411 Professional Park Dr
Marion, IL 62959-6394

Mailing address

3411 Professional Park Dr
Marion, IL 62959-6394
Phone (618) 969-8630

Other names 1

  • Kalinda Jo Dunning Former name

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
I20220811002408 IL Practitioner - Nurse Practitioner 9133502974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Deaconess Illinois Clinic IncGroup PAC ID 5092187021, 19 clinicians

Practice addresses (Care Compare)

1104 W Main St
Benton, IL 62812-1565
Phone (618) 439-3399

2700 W Deyoung St
Marion, IL 62959-4943
Phone (618) 969-8633

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.16 of 100Reported as group
Quality
70.69
Promoting interoperability
99
Improvement activities
40
Cost
71.02

Merit-based Incentive Payment System (MIPS)

Final score
77.51 of 100Reported as group
Quality
49.04
Promoting interoperability
95
Improvement activities
40
Cost
69.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041444043ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Clinic, Inc Nurse Practitioner CurrentSince Mar 14, 2023 Accepting new patients
Deaconess Illinois Clinic, Inc Nurse Practitioner CurrentSince Mar 14, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Clinic, Inc Nurse Practitioner Current Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner Current Accepting new patients
Deaconess Illinois Clinic, Inc Nurse Practitioner Past Accepting new patients
Deaconess Illinois Clinic, Inc Past Accepting new patients

Locations

205 Bailey Ln
Benton, IL 62812
Phone (618) 435-8189

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

716 S Commercial St
Harrisburg, IL 62946
Phone (618) 273-3361

1306 N Russell St
Marion, IL 62959
Phone (618) 997-2248

2700 W Deyoung St
Marion, IL 62959
Phone (618) 969-8633

3411 Professional Park Dr
Marion, IL 62959
Phone (618) 969-8630

509 Hamacher St
Waterloo, IL 62298
Phone (618) 939-3939

Interoperability endpoints

  • Direct secure messaging: kalinda.dunning.1@27782.direct.athenahealth.com
  • Direct secure messaging: kdunning288545@direct.deaconess.com

Organizations & group practices 8

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 9

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": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1851961635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 PROFESSIONAL PARK DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596394",
            "telephone_number": "618-969-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 PROFESSIONAL PARK DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596394",
            "telephone_number": "618-969-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KALINDA",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209023069",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023069",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041444043",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALINDA",
            "last_name": "DUNNING",
            "middle_name": "JO",
            "credential": "DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.