Kimberly J. Bankston, ANP
Individual provider Active NPI Family Nurse Practitioner · El Paso, IL
NPI 1962428003 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962428003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 20900121 (IL)
- Practice address
- 385 S Orange St
El Paso, IL 61738-1613 - Phone
- (309) 527-4900
- Fax
- (309) 527-3525
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Advanced Physical Therapy Services, LTD.
Bloomington Primary Care, LTD.
Practice addresses (Care Compare)
135 N Williamsburg Dr
Bloomington, IL 61704-3528
Phone (309) 664-9104
9 Heartland Dr
Suite C
Bloomington, IL 61704-7733
Phone 3096637642901
Hospital & facility affiliations
- Northwestern Medicine Central Dupage Hospital
- Carle Bromenn Medical Center
- St Joseph Medical Center
- Saint James Hospital
- Carle Eureka Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041209000842 | IL | Practitioner - Nurse Practitioner | 2567428634 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20900121 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Community Hospital Association | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 20900121 | IL | Yes |
Addresses
Primary practice location
385 S Orange St
El Paso, IL 61738-1613
Mailing address
PO Box 2451
Bloomington, IL 61702-2451
Phone (309) 268-2172
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5720935 | Other | BLUE CROSS BLUE SHIELD | |
| 10220308 | Other | BLUE CROSS BLUE SHIELD |
Other providers in El Paso, IL
- Cortney Ales
- Tamara Anderson
- Arc at El Paso LLC
- Arc at El Paso LLC
- Bromenn Physicians Management Corporation
- Alexander D Brucker
- Courtney Lee Button
- Carle Eureka Hospital
- Colby Lee Carr
All providers in El Paso, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.
- Order and Referring (CMS).
- 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.