Kathleen W. Smith, APN

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

209012013 Issued in IL

Practice address

900 Main Street Suite 280
Peoria, IL 61636-4688

Phone

(309) 643-6118

Fax

(309) 517-7476

NPI assigned

Oct 22, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Osf Saint Luke Medical Center Hospital, Kewanee, IL, CCN 141325
• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
• Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

• Osf Healthcare System

  • Critical Access Hospital
  • Princeton, IL
  • NPI 1093308439
  Care Compare affiliation
• Osf Healthcare System

  • Critical Access Hospital
  • Kewanee, IL
  • NPI 1871919381
  Care Compare affiliation
• St Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1992109755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10611 N SLEEPY HOLLOW RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151121",
            "telephone_number": "309-712-1363",
            "fax_number": "309-517-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN STREET SUITE 280",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616364688",
            "telephone_number": "309-643-6118",
            "fax_number": "309-517-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHLEEN",
        "middle_name": "W.",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.012013",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "209012013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina A Smith, LCSW
• Courtney Lynn Smith, MD
• Danielle J Smith, MD
• Jeanne Frances Smith, MD
• Julie A Smith
• Keely Bay Smith
• Kelley Scott Bond Smith, M.D.
• Kristin Smith, DO
• Kyle Daniel Smith
• Laura Smith, MD

• Adult Health Clinical Nurse Specialist in Peoria, IL
• Providers in Peoria, IL by specialty
• Adult Health Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.