KACIE L DAWSON (AGPCNP) – Gerontology Nurse Practitioner, NPI 1962123646

KACIE L DAWSON (AGPCNP) is a healthcare provider. based in Springfield, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials AGPCNP. They hold a License No. 209.025658 (IL). The NPI Number for KACIE L DAWSON (AGPCNP) is 1962123646

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KACIE L DAWSON (AGPCNP)
NPI
1962123646
Phone
(217) 545-8000
Address
201 E MADISON ST STE 328
Enumeration Date
9 September 2022
Last Update Date
15 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2173234055
Graduation Year
2022 (4 years ago)
PAC ID
6709262041
Group Practice PAC ID
2860616299
Professional Enrollment ID
I20221010002846
Address ID
IL626188384BE8306XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:3State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for KACIE L DAWSON (AGPCNP)

  • 201 E MADISON ST STE 328

    SPRINGFIELD, IL 627025131

    Phone: (217) 545-8000

    Fax: (217) 545-4410

    Type: Mailing

  • 520 N 4TH ST

    SPRINGFIELD, IL 627025238

    Phone: (217) 545-8000

    Type: Location

  • PO BOX 19639

    SPRINGFIELD, IL 627949639

    Phone: (217) 545-8000

    Type: Mailing

  • 319 E MADISON ST STE 1F

    SPRINGFIELD, IL 627013118

    Phone: (217) 545-8000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2022-10-10

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
I20221010002846INurse 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 62702)

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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: 2860616299View full group profile
NameSpecialtyState
General SurgeryMI
Internal MedicineIL
Nurse PractitionerIL
Nurse PractitionerIL
Physician AssistantIL

Reviews

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Frequently asked questions

Can I use this page to confirm KACIE L DAWSON (AGPCNP)'s NPI?
Yes. KACIE L DAWSON (AGPCNP) is listed with NPI 1962123646 in the public NPI dataset.
Is KACIE L DAWSON (AGPCNP) still practicing?
KACIE L DAWSON (AGPCNP) is currently listed as active in the public NPI registry.
What is KACIE L DAWSON (AGPCNP)'s primary classification?
Gerontology Nurse Practitioner is the headline specialty for KACIE L DAWSON (AGPCNP) here. Clinical services aligned with this taxonomy classification.
Does KACIE L DAWSON (AGPCNP) list a practice location?
Patients near Springfield, Illinois may find KACIE L DAWSON (AGPCNP) in results; validate coverage separately.
Is the information about KACIE L DAWSON (AGPCNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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