Danielle Klump, APRN
Individual provider Active NPI Family Nurse Practitioner · Du Quoin, IL
NPI 1972833770 · NPPES record last updated Feb 14, 2020
Key facts
- NPI
- 1972833770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 277.000024 (IL)
- Practice address
- 900 N Washington Street
Du Quoin, IL 62832 - Phone
- (217) 788-0706
- NPI assigned
- Dec 30, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pinckneyville Community Hospital
Practice addresses (Care Compare)
5383 State Route 154
Pinckneyville, IL 62274-3342
Phone 61835721875902
Hospital & facility affiliations
- Pinckneyville Community Hospital
- Marshall Browning Hospital
- Memorial Hospital of Carbondale
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 |
|---|---|---|---|---|
| I20100713000394 | IL | Practitioner - Nurse Practitioner | 6800928748 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-007720 | IL | MD | Family Nurse Practitioner |
| 277.000024 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marshall Browning Hospital Association | Current |
Accepting new patients | |
| Pinckneyville Community Hospital | Current |
Accepting new patients | |
| Marshall Browning Hospital Association | Current |
Accepting new patients | |
| Pinckneyville Community Hospital | Current |
Accepting new patients | |
| Prairie Cardiovascular Consultants LTD | Past | Accepting new patients |
Locations
900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050
5383 State Route 154
Pinckneyville, IL 62274
Phone (618) 357-2131
Interoperability endpoints
- danielle.klump@mbhdq.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 277.000024 | IL | Yes |
| Family Nurse Practitioner | 363LF0000X | 209-007720 | IL |
Addresses
Primary practice location
900 N Washington Street
Du Quoin, IL 62832
Mailing address
900 N Washington Street PO Box 192
Du Quoin, IL 62832
Phone (217) 788-0706
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 370661218401 | Medicaid | IL |
Other providers in Du Quoin, IL
- Chad R. Johnston
- Paul Brian Juergens
- Beth Keith-Mudgette
- Kidney Care Services of Southern Illinois, LTD
- Kims Family Healthcare LLC
- Alisha Kosma
- Carmen Krejci
- Farrah Kremer
- Katherine Laird
- Vaness Lawrence
All providers in Du Quoin, 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 Feb 14, 2020. 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.