Individual provider Active NPI

Janelle Renee Kirby, FNP-C

  • Family Nurse Practitioner
  • Mount Vernon, IL
National Provider Identifier
1942854526
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209019668 Issued in IL
Practice address
209 Crossroads PL Ste 120
Mount Vernon, IL 62864-6545
Phone
(618) 918-6045
Fax
(618) 918-6046
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209019668 IL
Family Nurse Practitioner 363LF0000X 209019668 IL Primary

Addresses

Primary practice location

209 Crossroads PL Ste 120
Mount Vernon, IL 62864-6545

Mailing address

209 Crossroads PL Ste 120
Mount Vernon, IL 62864-6545
Phone (618) 918-6045

Other practice location 1

205 Bailey Ln
Benton, IL 62812-1921
Phone (618) 882-4200

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
I20230816002249 IL Practitioner - Nurse Practitioner 8123356698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deaconess Illinois Specialty Clinic, Inc.Group PAC ID 9830562016, 145 clinicians

Practice addresses (Care Compare)

209 Crossroads PL
Mount Vernon, IL 62864-6545
Phone (618) 244-1937

Hospital & facility affiliations

  • Deaconess Illinois Crossroads Hospital, Mount Vernon, IL, CCN 140294
  • Heartland Regional Medical Center Hospital, Marion, IL, CCN 140184
  • Franklin Hospital Hospital, Benton, IL, CCN 141321
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011

Merit-based Incentive Payment System (MIPS)

Final score
77.51 of 100Reported as group
Quality
49.04
Promoting interoperability
95
Improvement activities
40
Cost
69.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209019668ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince Sep 21, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner CurrentSince Sep 21, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner Current Accepting new patients
Deaconess Illinois Clinic, Inc Past Accepting new patients

Locations

515 N Main St
Anna, IL 62906
Phone (618) 833-2872

205 Bailey Ln
Benton, IL 62812
Phone (618) 435-8189

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

209 Crossroads Pl
Mount Vernon, IL 62864
Phone (618) 242-4554

209 Crossroads Pl
Ste 120
Mount Vernon, IL 62864
Phone (618) 242-3119

509 Hamacher St
Waterloo, IL 62298
Phone (618) 939-3939

Interoperability endpoints

  • Direct secure messaging: janelle.kirby.1@27782.direct.athenahealth.com
  • Direct secure messaging: jkirby420382@direct.deaconess.com

Organizations & group practices 4

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 4

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": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1942854526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 CROSSROADS PL STE 120",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646545",
            "telephone_number": "618-918-6045",
            "fax_number": "618-918-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 CROSSROADS PL STE 120",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646545",
            "telephone_number": "618-918-6045",
            "fax_number": "618-918-6046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Bailey Ln",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "IL",
            "postal_code": "628121921",
            "country_code": "US",
            "telephone_number": "618-882-4200",
            "fax_number": "618-918-6046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "JANELLE",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209019668",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.