Individual provider Active NPI

Kimberly Rae Shulga, APRN, FNP-C

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1942143540
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.035221 Issued in IL
Practice address
3475 S Alpine Rd
Rockford, IL 61109-2604
Phone
(815) 874-8000
Fax
(815) 874-7525
NPI assigned
Apr 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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 209.035221 IL Primary

Addresses

Primary practice location

3475 S Alpine Rd
Rockford, IL 61109-2604

Mailing address

8547 River LN
Kingston, IL 60145-8205
Phone (815) 593-0549

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
I20260520002093 IL Practitioner - Nurse Practitioner 2062981939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

3475 S Alpine Rd
Rockford, IL 61109-2604
Phone (815) 874-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.035221ILMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1942143540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8547 RIVER LN",
            "city": "KINGSTON",
            "state": "IL",
            "postal_code": "601458205",
            "telephone_number": "815-593-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 S ALPINE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611092604",
            "telephone_number": "815-874-8000",
            "fax_number": "815-874-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULGA",
        "first_name": "KIMBERLY",
        "middle_name": "RAE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.035221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.