KIM A EARL (APRN, PMHNP, FNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063669497

KIM A EARL (APRN, PMHNP, FNP) is a healthcare provider. based in Springfield, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, PMHNP, FNP. They hold a License No. 209007155 (IL). The NPI Number for KIM A EARL (APRN, PMHNP, FNP) is 1063669497

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KIM A EARL (APRN, PMHNP, FNP)
NPI
1063669497
Phone
(217) 529-9266
Address
2200 Lake Victoria Dr
Enumeration Date
27 August 2008
Last Update Date
18 May 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2175233143
Graduation Year
2016 (10 years ago)
PAC ID
2567523541
Group Practice PAC ID
1355318825
Professional Enrollment ID
I20081209000575
Address ID
IL627032406SP1124XSTXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:17State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for KIM A EARL (APRN, PMHNP, FNP)

  • 2200 Lake Victoria Dr

    Springfield, IL 627035596

    Phone: (217) 529-9266

    Type: Location

  • 1124, South 6th Street, South Town, Hawthorne Place, Springfield, Sangamon County, Illinois, 62703, United States

    SPRINGFIELD, IL 627032406

    Phone: (217) 523-3143

    Fax: (217) 523-1513

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 159 Open Payments records for all available years, with a total value of $3,399.

Total Amount is formed as General ($3,399) + Research ($0) + Ownership ($0) = $3,399.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($848).

Total Amount

$3,399

General + Research + Ownership

Payments

159

Total payment records

General Amount

$3,399

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-12-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081209000575INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62703)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355318825View full group profile
NameSpecialtyState
Mental Health CounselorIL
Clinical PsychologistIL
P S Y C H I A T R YIL
Clinical Social WorkerIL
Nurse PractitionerIL
Mental Health CounselorIL

Reviews

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Frequently asked questions

Does KIM A EARL (APRN, PMHNP, FNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KIM A EARL (APRN, PMHNP, FNP) uses 1063669497.
Is KIM A EARL (APRN, PMHNP, FNP) still practicing?
KIM A EARL (APRN, PMHNP, FNP) is currently listed as active in the public NPI registry.
What is KIM A EARL (APRN, PMHNP, FNP)'s primary classification?
Psychiatric/Mental Health Nurse Practitioner is the headline specialty for KIM A EARL (APRN, PMHNP, FNP) here. Clinical services aligned with this taxonomy classification.
What address line appears for KIM A EARL (APRN, PMHNP, FNP)?
KIM A EARL (APRN, PMHNP, FNP)'s geographic hint is Springfield, Illinois in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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