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Active NPI 1538656145 Individual Practitioner Female Practitioner

Kelly Cotaleen Todd , PNP

Nurse Practitioner - Pediatrics • Walnut, IL

Professional Overview & Biography Verified Profile Summary

Kelly Todd, PNP is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Walnut, IL. Practice services are available at 25340 1300 EAST ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

25340 1300 East St

Walnut, IL 613769274

Telephone 8153106222
Associated Practice Facility / Clinic
🏢 Hope Chest Pediatrics Llc Facility NPI 1801511290

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Walnut, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.5 Yrs
Regional Practice Density
1 Specialists

Practicing in Walnut, IL (694 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

CMS Verified: 2022-08-02
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License IL 277001500

Definition to come...

Nurse Practitioner - Pediatrics

NUCC Taxonomy Code: 363LP0200X

State License MA MCS006520B

Definition to come...

Nurse Practitioner - Pediatrics

NUCC Taxonomy Code: 363LP0200X

State License MO 2018004205

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
420071827 (MO)

Secondary Practice Locations

300 Longwood Ave

Boston, MA 021155724

Phone: 6173556000

Career & Practice History Timeline

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

16 Historical Events
📍
Updated Practice Location August 02, 2022

Registered at 25340 1300 EAST ST, WALNUT, IL 613769274 (Tel: 8153106222)

📍
Updated Business Mailing Address August 02, 2022

Registered at 2646 PARK AVE, SAINT LOUIS, MO 631042024 (Tel: 8153106222)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 02, 2022

Nurse Practitioner (License #MCS006520B in MA)

📍
Updated Practice Location November 29, 2021

Registered at 1 CHILDRENS PL, DIV PED EMERGENCY MED, SAINT LOUIS, MO 631101002 (Tel: 3144542341)

📍
Updated Practice Location October 15, 2019

Registered at 1 CHILDRENS PL, SAINT LOUIS, MO 631101002 (Tel: 3144542341)

📍
Updated Business Mailing Address October 15, 2019

Registered at 1 CHILDRENS PL, MSC 8515-87-1200, SAINT LOUIS, MO 631101002 (Tel: 3144542341)

👤
Provider Name / Credentials Updated October 15, 2019

Recorded as KELLY TODD, PNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 15, 2019

Nurse Practitioner (License #2018004205 in MO)

📍
Updated Business Mailing Address July 18, 2018

Registered at 8711 DELMAR BLVD, APT 1W, SAINT LOUIS, MO 631241959 (Tel: 6366988300)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 18, 2018

Nurse Practitioner (License #209017344 in IL)

✅
NPI Profile Active April 18, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 18, 2018

Registered at 4100 FOREST PARK AVE, SAINT LOUIS, MO 631082806 (Tel: 6366988300)

📍
Updated Business Mailing Address April 18, 2018

Registered at 4100 FOREST PARK AVE, SAINT LOUIS, MO 631082806 (Tel: 6366988300)

👤
Provider Name / Credentials Updated April 18, 2018

Recorded as KELLY TODD, CPNP-AC/PC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 18, 2018

Nurse Practitioner (License #2018004205 in MO)

🟢
Initial NPI Registration & Enumeration April 18, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1538656145
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 18, 2018
Last Update: August 02, 2022
Sole Proprietor: No
Update or Correct Profile

Mailing Address

2646 Park Ave

Saint Louis, MO 631042024

Phone: 8153106222

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.