Individual provider Active NPI

Keri Ashmore, NP

  • Family Nurse Practitioner
  • Mount Vernon, IL
National Provider Identifier
1891593315
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209031754 Issued in IL
Practice address
1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone
(618) 899-1255
NPI assigned
Mar 3, 2025
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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 209031754 IL Primary

Addresses

Primary practice location

1 Good Samaritan Way
Mount Vernon, IL 62864-2402

Mailing address

502 W Richland Ave
Effingham, IL 62401-2554
Phone (217) 218-8426

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
I20250613003432 IL Practitioner - Nurse Practitioner 3072024314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Emergency Good Samaritan, IncGroup PAC ID 1658529342, 28 clinicians
Midwest Emergency Centralia Campus Associates, Inc.Group PAC ID 2163672650, 15 clinicians

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (618) 242-4600

400 N Pleasant Ave
St Mary's Hospital Centralia Il
Centralia, IL 62801-3056
Phone (618) 436-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209031754ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Emergency Centralia Campus Associates, Inc CurrentSince Apr 24, 2025 Accepting new patients
Midwest Emergency Good Samaritan, Inc CurrentSince Apr 24, 2025 Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

911 Stacey Burk Dr
Flora, IL 62839
Phone (618) 662-2161

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

Interoperability endpoints

  • Direct secure messaging: kashmore536900@direct-ehr-ssmhc.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 2

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": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1891593315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W RICHLAND AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012554",
            "telephone_number": "217-218-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GOOD SAMARITAN WAY",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642402",
            "telephone_number": "618-899-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHMORE",
        "first_name": "KERI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209031754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.