KIMBERLY RENE CLAFFEY FNP-C
NPI 1194495424
Nurse Practitioner - Family in Mount Vernon, IL

Q: What is Kimberly Claffey's NPI number?

The NPI number for Kimberly Claffey is 1194495424. It was assigned to this individual provider in the NPPES registry on September 17, 2021.

Q: What is Kimberly Claffey's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Claffey was last updated on September 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 17, 2021PECOS EnrolledAccepts Medicare Assignment

5100 LAKE TER NE STE WC, MOUNT VERNON, IL 62864(618) 899-5001(618) 242-5152 Get Directions Write a Review

NPPES record last updated: September 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Kimberly Rene Claffey Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY RENE CLAFFEY FNP-C (NPI 1194495424) is an individual family provider in Mount Vernon, Illinois, licensed in Illinois (209.024017) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1194495424

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKIMBERLY RENE CLAFFEYCredential: FNP-C

Location Address5100 LAKE TER NE STE WCMount Vernon, IL 62864-9665

Mailing Address5100 Lake Ter Ne Ste WcMount Vernon, IL 62864-9665 · (618) 899-5001 · Fax (618) 242-5152

Phone(618) 899-5001

Fax(618) 242-5152

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateSeptember 17, 2021

NPPES CertifiedSeptember 17, 2021

✔ NPI 1194495424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209.024017

5100 LAKE TER NE STE WC, Mount Vernon, IL 62864

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimberly Rene Claffey Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830588086

PECOS Enrollment IDI20211110001079

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kimberly Claffey reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Premise Health Of Illinois Medical PC

Same address

Primary Care

5100 LAKE TERRANCE NE
Mount Vernon, IL 62864

Reassigned Medicare billing, Illinois enrollment
66 clinicians in this Medicare group

NPI 1427366921 (618) 899-5001

Physician Services Corporation Of Southern Illinois Inc.

1.3 mi

Internal Medicine

4218 LINCOLNSHIRE DR
Mount Vernon, IL 62864

Reassigned Medicare billing, Illinois enrollment
296 clinicians in this Medicare group

NPI 1831101807 (618) 899-3600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62864 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMANDA ENGELE FNP-C

Nurse Practitioner (Family)

5100 LAKE TER NE STE WC
MOUNT VERNON, IL 62864

Jefferson County (618) 899-5001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Claffey's NPI number?

The NPI number for Kimberly Claffey is 1194495424. It was assigned to this individual provider in the NPPES registry on September 17, 2021.

Where is Kimberly Claffey located?

Kimberly Claffey practices at 5100 Lake Ter NE Ste Wc, Mount Vernon, IL 62864. The listed phone number is (618) 899-5001.

What is Kimberly Claffey's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kimberly Claffey enrolled in Medicare?

Yes. Kimberly Claffey is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kimberly Claffey's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Claffey reassigns Medicare benefits to 2 organizations: Premise Health Of Illinois Medical PC (Mount Vernon, IL) and Physician Services Corporation Of Southern Illinois Inc. (Mount Vernon, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Claffey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kimberly Claffey was last updated on September 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.