Jennifer Elizabeth Kistner, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209008758 Issued in IL

Practice address

203 S Main St
Dieterich, IL 62424

Phone

(217) 925-5730

Fax

(217) 925-5736

NPI assigned

Apr 6, 2011

Last updated

Jun 30, 2022By 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

Other identifiers 2

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HSHS Home Care Illinois Home health agency, Effingham, IL, CCN 147661
• St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032
• St Johns Hospital Hospital, Springfield, IL, CCN 140053
• Sarah Bush Lincoln Health Center Hospital, Mattoon, IL, CCN 140189
• St Marys Hospital Hospital, Decatur, IL, CCN 140166

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkistner197359@ewd.direct.hshs.org

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.

• HSHS Prairie, Inc

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1962644807
  Medicare reassignment Care Compare group NPD
• HSHS Prairie, Inc

  dba HSHS Medical Group Family Medicine - Dieterich

  • Rural Health Clinic/Center
  • Dieterich, IL
  • NPI 1033841192
  NPD
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Rushville, IL
  • NPI 1487719480
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  dba St. Anthony's Memorial Hospital

  • General Acute Care Hospital
  • Effingham, IL
  • NPI 1306800602
  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  dba St. Anthony's Memorial Hospitral

  • Clinic/Center
  • Effingham, IL
  • NPI 1881214104

  Hospital

  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  dba HSHS Home Care Illinois

  • Home Health Agency
  • Effingham, IL
  • NPI 1891758678
  Care Compare affiliation
• St Johns Hospital of the Hospital Sisters of the Third Order of St F

  dba HSHS St. John's Hospital

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1205818481
  Care Compare affiliation
• St Marys Hospital Decatur of the Hospital Sisters of the Third Order

  dba St Marys Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1326041229
  Care Compare affiliation

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1972892313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 NETWORK CENTRE DR STE 3",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014632",
            "telephone_number": "217-347-2707",
            "fax_number": "217-347-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S MAIN ST",
            "city": "DIETERICH",
            "state": "IL",
            "postal_code": "62424",
            "telephone_number": "217-925-5730",
            "fax_number": "217-925-5736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "512 N Maple St",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624012005",
            "country_code": "US",
            "telephone_number": "217-347-7030",
            "fax_number": "217-347-7049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISTNER",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209008758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041359392",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "209008758",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkistner197359@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "203 S Main St",
            "city": "Dieterich",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dieterich Comm Unit 30
• HSHS Prairie, Inc (HSHS Medical Group Family Medicine - Dieterich)
• Abigail Ellen Jansen, M.S., LCPC
• Jennifer Tinsley Pmhnp-BC, PLLC (Life Story Behavioral Health)
• Kristen Rose Kennedy, M.S. CCC-SLP
• Debra Kitten
• Angela Koester, COTA/L
• Morgan Rae Lidy
• Julie Marie Loy, M.A. CCC/SLP
• Mid-Illinois Medical Care Associates, LLC (Dieterich Community Medical Center)

• Nurse Practitioner in Dieterich, IL
• Providers in Dieterich, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.