NPIMap

Individual provider Active NPI

Kevin M. Jeffries, M.D.

  • Family Medicine Physician
  • Galva, IL
National Provider Identifier
1871541615
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036090015 Issued in IL
Practice address
336 Front St
Galva, IL 61434-1365
Phone
(309) 932-3101
Fax
(309) 932-3154
NPI assigned
May 4, 2006
Last updated
Oct 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036090015 IL Primary

Addresses

Primary practice location

336 Front St
Galva, IL 61434-1365

Mailing address

336 Front St
Galva, IL 61434-1365
Phone (309) 932-3101

Other identifiers 1

IdentifierTypeStateIssuer
036090015MedicaidIL

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
I20040514000499 IL Practitioner - Family PracticePractitioner - Pain ManagementPractitioner - Emergency Medicine 3173513843 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hammond Henry Dist HospitalGroup PAC ID 0143115949, 41 clinicians

Practice addresses (Care Compare)

1258 W S St
Suite 2
Kewanee, IL 61443-8300
Phone (309) 853-3677

600 N College Ave
Geneseo, IL 61254-1007
Phone (309) 944-9124

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Hammond Henry Dist Hospital CurrentSince May 1, 2017 Accepting new patients
Regional Family Health Center Family Medicine PastSince Jun 3, 2004 Accepting new patients
Regional Family Health Center Family Medicine Past Accepting new patients
New Century Physicians of Western Illinois, Inc Past Accepting new patients

Locations

600 N College Ave
Geneseo, IL 61254
Phone (309) 944-6431

1258 W South St
Ste 2
Kewanee, IL 61443
Phone (309) 853-3667

Interoperability endpoints

  • Direct secure messaging: kevinjeffries@xdrhammondhenryrhp.org
  • Direct secure messaging: kjeffries548341@direct.unitypoint.org

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 5

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1871541615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 FRONT ST",
            "city": "GALVA",
            "state": "IL",
            "postal_code": "614341365",
            "telephone_number": "309-932-3101",
            "fax_number": "309-932-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 FRONT ST",
            "city": "GALVA",
            "state": "IL",
            "postal_code": "614341365",
            "telephone_number": "309-932-3101",
            "fax_number": "309-932-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "KEVIN",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036090015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090015",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galva, IL

Sources for this page

Verify at the official NPI Registry.