Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kellie Bibb

Individual provider Family Nurse Practitioner · NPI 1699147215

Kellie Bibb is a Nurse Practitioner in Springfield, Illinois. Qualified in 2015, 11 years ago. Practices with Memorial Physician Services, a 158-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
11
Licensed in
IL
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

3220 Atlanta St
Springfield, IL 62707-8801
Phone: (217) 588-2600
Fax: (217) 862-0202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 277.000110 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209013401 (IL)

Record details

NPI number1699147215
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 22, 2015
Last updated in NPPESJuly 19, 2022
Certification dateJuly 19, 2022
Mailing addressPo Box 3428, Springfield, IL 62708-3428

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Memorial Physician Services — 158 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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