Individual provider Active NPI

Kristin R Reese, PA

  • Physician Assistant
  • Rockford, IL
National Provider Identifier
1891715959
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085002538 Issued in IL
Practice address
2473 McFarland Rd
Rockford, IL 61107-6824
Phone
(779) 696-9202
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085002538 IL Primary

Addresses

Primary practice location

2473 McFarland Rd
Rockford, IL 61107-6824

Mailing address

PO Box 1567
Rockford, IL 61110-0067

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
I20051104000759 IL Practitioner - Physician Assistant 3476571704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

698 Featherstone Rd
Rockford, IL 61107-6303
Phone (815) 398-3277

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Osf Healthcare Home Care Home health agency, Loves Park, IL, CCN 147271
  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital CurrentSince Aug 1, 2008 Accepting new patients
Osf Multi-Specialty Group CurrentSince Mar 23, 2016 Accepting new patients
Swedishamerican Hospital CurrentSince Aug 1, 2008 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Swedishamerican Hospital Past Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2473 McFarland Rd
Rockford, IL 61107
Phone (779) 696-0020

698 Featherstone Rd
Rockford, IL 61107
Phone (815) 398-3277

1340 Charles St
Rockford, IL 61104
Phone (779) 696-5888

698 Featherstone Rd
Ste 250
Rockford, IL 61107
Phone (815) 399-4404

Organizations & group practices 5

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 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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1891715959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1567",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611100067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2473 MCFARLAND RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076824",
            "telephone_number": "779-696-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "KRISTIN",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.