KIMBERLY NICHOLSON (APN) – Nurse Practitioner, NPI 1245636026

KIMBERLY NICHOLSON (APN) is a healthcare provider. based in Long grove, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APN. They hold a License No. 209012143 (IL). The NPI Number for KIMBERLY NICHOLSON (APN) is 1245636026

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY NICHOLSON (APN)
NPI
1245636026
Phone
(847) 719-2220
Address
3880 SALEM LAKE DR STE F
Enumeration Date
6 November 2014
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8473819600
Graduation Year
2014 (12 years ago)
PAC ID
6709008345
Group Practice PAC ID
5799687372
Professional Enrollment ID
I20141114000230
Address ID
IL600101919BA450XX22XX400

Contacts

FHIR Endpoint
https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Secure Messaging
knicholson317682@direct.myadvocatecaurora.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:11State licenses:1Other namesUpdated within 12 months

11,632 NURSE PRACTITIONER in IL

Provider Addresses for KIMBERLY NICHOLSON (APN)

  • 3880 SALEM LAKE DR STE F

    LONG GROVE, IL 600475292

    Phone: (847) 719-2220

    Fax: (847) 719-2265

    Type: Location

  • 170 N LAKEWOOD RD

    LAKE IN THE HILLS, IL 601565944

    Phone: (224) 569-4000

    Fax: (877) 686-5642

    Type: Mailing

  • 800 E Woodfield Rd Ste 113

    Schaumburg, IL 601734786

    Phone: (847) 686-6866

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $71.

Total Amount is formed as General ($71) + Research ($0) + Ownership ($0) = $71.

Last reported payment date: 2024-06-21 • Largest payer in this snapshot: Dexcom, Inc. ($39).

Total Amount

$71

General + Research + Ownership

Payments

2

Total payment records

General Amount

$71

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-21

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Dexcom, Inc.$39
Lilly USA, LLC$32
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: 2014-11-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-11-30 (922 days ago).

Enrollment records

1

Earliest due date

2023-11-30

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
I20141114000230INurse PractitionerIL2023-11-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes3517$0
99239Hospital discharge day management, more than 30 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 60047)

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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: 5799687372View full group profile
NameSpecialtyState
Internal MedicineIL
Internal MedicineIL
Nurse PractitionerIL
Nurse PractitionerIL
Family PracticeIL
Family PracticeIL
Internal MedicineIL
Internal MedicineIL
Internal MedicineIL
-IL

Reviews

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Frequently asked questions

Can I cross-check KIMBERLY NICHOLSON (APN) using NPI 1245636026?
NPI 1245636026 belongs to KIMBERLY NICHOLSON (APN); compare other details if you need extra assurance.
Would KIMBERLY NICHOLSON (APN) appear as active to a payer?
You can treat KIMBERLY NICHOLSON (APN) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is KIMBERLY NICHOLSON (APN)?
KIMBERLY NICHOLSON (APN) is associated with Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is KIMBERLY NICHOLSON (APN) associated with Long Grove?
Public fields place KIMBERLY NICHOLSON (APN) around Long Grove, Illinois. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for KIMBERLY NICHOLSON (APN) is noted as November 6, 2014 where the registry provides it.

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