Kimberly Sue Booker, PT
Individual provider Active NPI Physical Therapist · Anna, IL
NPI 1942248372 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1942248372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 517 N Main St
Anna, IL 62906-1668 - Phone
- (618) 833-9694
- NPI assigned
- Jun 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Integrated Health of Southern Illinois LTD
Practice addresses (Care Compare)
303 S Commercial St
Suite 10
Harrisburg, IL 62946-2125
Phone (618) 252-5555
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210514001086 | IL | Practitioner - Physical Therapist in Private Practice | 2668881012 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070012254 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Health of Southern Illinois, LTD. | Physical Therapist | Current |
Accepting new patients |
| Integrated Health of Southern Illinois | Physical Therapist | Current |
Accepting new patients |
Locations
310 W Plaza Dr
Carterville, IL 62918
Phone (618) 525-0719
303 S Commercial St
Ste 10
Harrisburg, IL 62946
Phone (618) 252-5555
Interoperability endpoints
- kimberly.booker.1@26231.direct.athenahealth.com
- https://api.platform.athenahealth.com/26231/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Yes |
Addresses
Primary practice location
517 N Main St
Anna, IL 62906-1668
Mailing address
340 Melody LN
Murphysboro, IL 62966-4508
Phone (618) 565-1104
Other providers in Anna, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. 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.
- 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.