Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1992158356 Individual Practitioner Female Practitioner

Kendra Mickelson

Skilled Nursing Facility • Eureka, IL

Professional Overview & Biography Verified Profile Summary

Kendra Mickelson is a registered healthcare professional specializing in Skilled Nursing Facility in Eureka, IL. Practice services are available at 700 N MAIN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

700 N Main St

Eureka, IL 615301085

Telephone 3094679094
Fax 3094679011
Associated Practice Facility / Clinic
🏢 Maple Lawn Health Center Facility NPI 1720073414

Specialty Benchmarks & Practice Insights

Comparative analytics for Skilled Nursing Facility in Eureka, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 27.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Eureka, IL (42 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Skilled Nursing Facility Primary Specialty

NUCC Taxonomy Code: 314000000X

State License IL 0042424

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Skilled Nursing Facility

NUCC Taxonomy Code: 314000000X

State License IL 1694647

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0042424 (IL)
Commercial Insurance / Payer ID Taxonomy Number
314000000X (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Edward Hodel , PT

Physical Therapist

NPI 1043658743

Physical Therapist

Jesse Kolb , COTA

Occupational Therapy Assistant

NPI 1346835105

Certified Occupational Therapy Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 20, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location July 20, 2016

Registered at 700 N MAIN ST, EUREKA, IL 615301085 (Tel: 3094679094)

📍
Updated Business Mailing Address July 20, 2016

Registered at 700 N MAIN ST, EUREKA, IL 615301085 (Tel: 3094679094)

👤
Provider Name / Credentials Updated July 20, 2016

Recorded as KENDRA MICKELSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 20, 2016

Skilled Nursing Facility (License #0042424 in IL)

🟢
Initial NPI Registration & Enumeration July 20, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992158356
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 20, 2016
Last Update: July 20, 2016
Sole Proprietor: Yes

Mailing Address

700 N Main St

Eureka, IL 615301085

Phone: 3094679094

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.