Kelly M Whitaker, NP is a medicare enrolled "Nurse Practitioner - Adult Health" in Freeburg, Illinois. She graduated from nursing school in 2011 and has 13 years of diverse experience with area of expertise as Nurse Practitioner. Her current practice location is
746 Urbanna Dr, Freeburg, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 792-3586.
Kelly M Whitaker is licensed to practice in Illinois (license number 209.008885041.354586) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1386932028.
Provider's Profile
| Full Name | Kelly M Whitaker |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 13 Years |
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| Location | 746 Urbanna Dr, Freeburg, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kelly M Whitaker graduated from nursing school in 2011
NPI Data:
- NPI Number: 1386932028
- Provider Enumeration Date: 07/15/2011
- Last Update Date: 12/21/2023
Medicare PECOS Information:
- PECOS PAC ID: 3476723966
- Enrollment ID: I20110818000568
Medical Identifiers
Medical identifiers for Kelly M Whitaker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1386932028 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2200X | Nurse Practitioner - Adult Health | 209.008885041.354586 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly M Whitaker allows following entities to bill medicare on her behalf.
| Entity Name | Advanced Practice Nursing Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861867863
PECOS PAC ID: 4183908999
Enrollment ID: O20170222002252 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly M Whitaker is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kelly M Whitaker, NP
Po Box 303,
Mascoutah, IL 62258-0303
Ph: (618) 792-3586 | Kelly M Whitaker, NP
746 Urbanna Dr,
Freeburg, IL 62243-1904
Ph: (618) 792-3586 |
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