KIMBERLY J MITCHELL – Family Nurse Practitioner, NPI 1700350170
Family Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for KIMBERLY J MITCHELL
5, Kennedy Drive, Granite City, Madison County, Illinois, 62040, United States
GRANITE CITY, IL 620401851
Phone: (618) 504-0908
Type: Mailing
4625 Lindell Blvd Ste 200
Saint Louis, MO 631083725
Phone: (866) 949-0108
Type: Location
1 Westbrook Corporate Ctr Ste 300
Westchester, IL 601545709
Phone: (866) 949-0108
Type: Location
3354 Jerome Ln
Cahokia, IL 622062604
Phone: (618) 484-7850
Type: Location
5 Kennedy Dr
Granite City, IL 62040
Phone: (618) 504-0908
Type: Location
2420 STATE ST
EAST SAINT LOUIS, IL 622052321
Phone: (618) 318-8809
Fax: (618) 615-4205
Type: Location
PO BOX 746715
ATLANTA, GA 303746715
Phone: (773) 352-1515
Fax: (312) 929-0373
Type: Mailing
3354 JEROME LN
CAHOKIA, IL 622062604
Phone: (618) 484-7850
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $1,098.
Total Amount is formed as General ($1,098) + Research ($0) + Ownership ($0) = $1,098.
Last reported payment date: 2024-10-09 • Largest payer in this snapshot: ACADIA Pharmaceuticals Inc ($442).
Total Amount
$1,098
General + Research + Ownership
Payments
11
Total payment records
General Amount
$1,098
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ACADIA Pharmaceuticals Inc | $442 |
| AstraZeneca Pharmaceuticals LP | $200 |
| Amgen Inc. | $189 |
| Neurocrine BioSciences, Inc. | $125 |
| Phathom Pharmaceuticals, Inc. | $125 |
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: 2020-12-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20200228000523 | I | Nurse Practitioner | MO | TBD |
| I20200330001071 | I | Nurse Practitioner | IL | TBD |
| I20201218002018 | I | Nurse Practitioner | IN | 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 62040)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO |
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