KEISHA NICOLE HOUSE – Family Nurse Practitioner, NPI 1619400074
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for KEISHA NICOLE HOUSE
18560, John Avenue, Country Club Hills, Rich Township, Cook County, Illinois, 60478, United States
COUNTRY CLUB HILLS, IL 604785251
Phone: (773) 655-0899
Type: Mailing
3240 W DIVISION ST
CHICAGO, IL 606512405
Phone: (312) 413-7425
Fax: (312) 413-2588
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $177.
Total Amount is formed as General ($177) + Research ($0) + Ownership ($0) = $177.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Indivior Inc. ($155).
Total Amount
$177
General + Research + Ownership
Payments
5
Total payment records
General Amount
$177
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Indivior Inc. | $155 |
| Exact Sciences Corporation | $23 |
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: 2018-01-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180109001248 | I | Nurse Practitioner | IL | TBD |
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.
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 60478)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | IL | |
| P S Y C H I A T R Y | IL | |
| P S Y C H I A T R Y | IL | |
| Internal Medicine, Addiction Medicine | IL | |
| - | IL |
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