Brooke Kennard, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209-014496 Issued in IL

Practice address

326 Fairway Dr
Bloomington, IL 61701-3462

Phone

(309) 451-9595

Fax

(309) 451-9583

NPI assigned

Nov 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1902348493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 BROAD CREEK RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048525",
            "telephone_number": "309-532-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 FAIRWAY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013462",
            "telephone_number": "309-451-9595",
            "fax_number": "309-451-9583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 N Delaware St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462042599",
            "country_code": "US",
            "telephone_number": "317-257-9151",
            "fax_number": "317-247-9159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNARD",
        "first_name": "BROOKE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008773A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-014496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett L. Keller, D.O.
• John B Keller, D.D.S.
• Kimberly A. Keller, OT
• Bonny Kelley
• Adam Kelly
• Mychele Kenney, LCPC
• Tom Kenney
• Julie D. Kenny, AUD
• Kent S Taulbee MD SC
• Claire Therese Keogh

• Family Nurse Practitioner in Bloomington, IL
• Providers in Bloomington, 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 Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.