Kacie Danielle Zielsdorf, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209027337 Issued in IL

Practice address

809 W Church St
Champaign, IL 61820-3320

Phone

(217) 373-1700

NPI assigned

May 1, 2023

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pavilion Foundation

  • Psychiatric Hospital
  • Champaign, IL
  • NPI 1518930619
  NPD

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1992494595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63",
            "city": "ARROWSMITH",
            "state": "IL",
            "postal_code": "617220063",
            "telephone_number": "309-706-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 W CHURCH ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203320",
            "telephone_number": "217-373-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIELSDORF",
        "first_name": "KACIE",
        "middle_name": "DANIELLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209027337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant A. Zehr, M.D.
• Haley Zeien, LSW
• David R Zeman, MD
• Carolyn Zhang, APRN, FNP-C
• Bethany Lynn Zich, PT, DPT, ATC
• Isabella Zigler
• Mark Huang Zinger, LSW
• Misty Zipprich
• Caleigh Zolman
• Ryan Michelle Zook

• Psychiatric/Mental Health Nurse Practitioner in Champaign, IL
• Providers in Champaign, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.