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

Mrs. Kellsey R Thole, NP

Individual provider Cardiovascular Disease Physician · NPI 1407397862

Mrs. Kellsey R Thole, NP is a Nurse Practitioner in O Fallon, Illinois. Qualified in 2016, 10 years ago. Practices with Prairie Cardiovascular Consultants Ltd, a 94-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
10
Licensed in
IL
In the registry since
2017
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

Three Saint Elizabeth Blvd Ste 2800
O Fallon, IL 62269-1282
Phone: (618) 233-6044
Fax: (833) 973-4218
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 209.015758 (IL)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 209.015758 (IL)

Record details

NPI number1407397862
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedMarch 17, 2017
Last updated in NPPESDecember 20, 2021
Certification dateDecember 20, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Prairie Cardiovascular Consultants Ltd — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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