Kimberly Ann Medlin, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209010951 Issued in IL

Practice address

1835 Dixie Hwy 100
Flossmoor, IL 60422-1974

Phone

(708) 799-8384

NPI assigned

Nov 20, 2013

Last updated

Nov 3, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Riveredge Hospital Inc

  • Psychiatric Hospital
  • Forest Park, IL
  • NPI 1710070701
  Medicare reassignment NPD
• Asad Zaman MD SC

  • Internal Medicine Physician
  • Tinley Park, IL
  • NPI 1356393557
  NPD

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1952731325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 DIXIE HWY 100",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221974",
            "telephone_number": "708-799-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 DIXIE HWY 100",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221974",
            "telephone_number": "708-799-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLIN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-20",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick L McGinnis, MD
• McKeever Health and Clinical Services, LLC
• Kelley McKeever, PSY. D.
• Catherine C McPhearson-Jackson
• Medcentrix Inc (ingalls pro pharm 3)
• Medonc LTD
• Rachel Medrano, PHARMD
• Meijer Great Lakes Limited Partnership (Meijer Pharmacy #280)
• Krystal Merchant, REGISTERED NURSE
• Michelle Mesch

• Family Nurse Practitioner in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.