Kristine M Costello, ANP
Individual provider Active NPI Family Nurse Practitioner · Godfrey, IL
NPI 1922469402 · NPPES record last updated Sep 26, 2025
Key facts
- NPI
- 1922469402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209013674 (IL)
- Practice address
- 5213 Godfrey Rd Ste 110
Godfrey, IL 62035-2510 - Phone
- (618) 619-3330
- NPI assigned
- Mar 11, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fairview Heights Medical Group SC
Practice addresses (Care Compare)
1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240
163 E Bethalto Dr
Bethalto, IL 62010-1801
Phone (618) 433-6640
5213 Godfrey Rd
Suite 110
Godfrey, IL 62035-2510
Phone (618) 619-3330
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160413001232 | IL | Practitioner - Nurse Practitioner | 5496053183 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016000994 | MO | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Heights Medical Group SC | Current |
Accepting new patients | |
| Fairview Heights Medical Group SC | Current |
Accepting new patients | |
| Ahs Il Medical Group LLC | Current |
Accepting new patients |
Locations
1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240
1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870
163 E Bethalto Dr
Bethalto, IL 62010
Phone (618) 433-6490
1000 Eleven S
Ste 1A
Columbia, IL 62236
Phone (618) 281-8400
2122 Troy Rd
Ste 130
Edwardsville, IL 62025
Phone (618) 692-9876
4273 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-2297
5520 Godfrey Rd
Ste B
Godfrey, IL 62035
Phone (618) 463-7800
5520 Godfrey Rd
Godfrey, IL 62035
Phone (618) 463-7800
5213 Godfrey Rd
Ste 110
Godfrey, IL 62035
Phone (618) 619-3330
2100 Madison Ave
Ste 301
Granite City, IL 62040
2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000
8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500
670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 953-8250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2016000994 | MO | |
| Family Nurse Practitioner | 363LF0000X | 209013674 | IL | Yes |
Addresses
Primary practice location
5213 Godfrey Rd Ste 110
Godfrey, IL 62035-2510
Mailing address
670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141-8573
Phone (618) 463-7800
Other practice location 1
5520 Godfrey Rd Ste B
Godfrey, IL 62035-2741
Phone (618) 463-7800
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Other providers in Godfrey, IL
- Joshua Seth Brunaugh
- Cep America - Illinois SNF, LLP
- Kristin Anne Childers
- Clarkson Optometry Illinois, P.C.
- Community College District 536
- Larry Wayne Crocker
- Barbara Lynn Dierking
- Allison Marie Doyle
- Dr. Kimberly D. Haug, PC
- Tracy Dawn Ducey
All providers in Godfrey, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.