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MRS. FELICIA DESHA KIMBROUGH FNP BC
NPI 1679740708
Nurse Practitioner in Carbondale, IL

Active since May 08, 2008PECOS Enrolled
1301 E WALNUT ST RM J120, CARBONDALE, IL 62901(618) 519-9200(618) 457-8931 Get Directions Write a Review

NPPES record last updated: August 16, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 16, 2022, Dec 11, 2020 (2 updates tracked since 2020).

About Mrs. Felicia Desha Kimbrough Fnp Bc NPPES

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

MRS. FELICIA DESHA KIMBROUGH FNP BC (NPI 1679740708) is an individual nurse practitioner in Carbondale, Illinois, licensed in Illinois (209007991) and active in the NPI registry since May 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679740708
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. FELICIA DESHA KIMBROUGHCredential: FNP BC
Location Address1301 E WALNUT ST RM J120Carbondale, IL 62901-5004
Mailing Address109 California StCarterville, IL 62918-1923 · (618) 985-8221 · Fax (618) 985-6860
Phone(618) 519-9200
Fax(618) 457-8931
Sole ProprietorNo
Enumeration DateMay 8, 2008
Last NPPES UpdateAugust 16, 20222 updates tracked since enumeration
NPPES CertifiedAugust 16, 2022
✔ NPI 1679740708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IL · 209007991
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1301 E WALNUT ST RM J120, Carbondale, IL 62901
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Other Identifiers 4

Medicaid406333266001IL
Medicaid370966854002IL
Medicaid370966854005IL
OtherCF3444IL · Medicare Rr

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Felicia Desha Kimbrough Fnp Bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Felicia Kimbrough reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shawnee Health Service And Development Corp
Same address
Federally Qualified Health Center (FQHC)
1301 E WALNUT ST RM J120
Carbondale, IL 62901
  • Reassigned Medicare billing, Illinois enrollment
  • 52 clinicians in this Medicare group
NPI 1326079245 (618) 457-3371

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 62901 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 2

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

JOHN KEEHN LCSW
Social Worker (Clinical)
1301 E WALNUT ST RM J120
CARBONDALE, IL 62901
Jackson County (618) 519-9200
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Clinic/Center (Federally Qualified Health Center (FQHC))
1301 E WALNUT ST RM J120
CARBONDALE, IL 62901
Jackson County (618) 457-3371

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 Felicia Kimbrough's NPI number?

The NPI number for Felicia Kimbrough is 1679740708. It was assigned to this individual provider in the NPPES registry on May 8, 2008.

Where is Felicia Kimbrough located?

Felicia Kimbrough practices at 1301 E Walnut St Rm J120, Carbondale, IL 62901. The listed phone number is (618) 519-9200.

What is Felicia Kimbrough's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Felicia Kimbrough enrolled in Medicare?

Yes. Felicia Kimbrough is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Felicia Kimbrough's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Felicia Kimbrough reassigns Medicare benefits to Shawnee Health Service And Development Corp (Carbondale, IL). The 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 Felicia Kimbrough'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 Felicia Kimbrough was last updated on August 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.