Individual provider Active NPI

Kelly Rankin, PA-C

  • Physician Assistant
  • Joliet, IL
National Provider Identifier
1932448396
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004503 Issued in IL
Practice address
2202 Essington Rd
Suite 101
Joliet, IL 60435-1634
Phone
(815) 676-5310
Fax
(815) 725-1321
NPI assigned
Feb 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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 085004503 IL Primary

Addresses

Primary practice location

2202 Essington Rd
Suite 101
Joliet, IL 60435-1634

Mailing address

2202 Essington Rd
Suite 101
Joliet, IL 60435-1634
Phone (815) 676-5310

Other identifiers 1

IdentifierTypeStateIssuer
085004503OtherILSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131031000715 IL Practitioner - Physician Assistant 8426283326 Reassigns benefits to 1 organization
I20191014001209 IN Practitioner - Physician Assistant 8426283326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

1124 Essington Rd
Suite a
Joliet, IL 60435-8442
Phone (815) 744-8554

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Past Accepting new patients
Dermatology and Plastic Surgery Associates, S.C. PastSince Apr 3, 2017 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: krankin@directaddress.net

Organizations & group practices 3

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 1

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": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1932448396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 ESSINGTON RD",
            "address_2": "SUITE 101",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351634",
            "telephone_number": "815-676-5310",
            "fax_number": "815-725-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 ESSINGTON RD",
            "address_2": "SUITE 101",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351634",
            "telephone_number": "815-676-5310",
            "fax_number": "815-725-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANKIN",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085004503",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.