Misty Lynn Dehaven, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209018358 Issued in IL

Practice address

1639 N Alpine Rd Ste 260
Rockford, IL 61107-1481

Phone

(815) 395-1500

Fax

(815) 395-1415

NPI assigned

Nov 13, 2018

Last updated

Feb 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Freeport Regional Health Care FoundationGroup PAC ID 9234041682, 86 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• FHN Memorial Hospital Hospital, Freeport, IL, CCN 140160

Merit-based Incentive Payment System (MIPS)

Final score

83.84 of 100Reported as group

Quality

75.22

Promoting interoperability

92

Improvement activities

40

Cost

73.11

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fhncounselingctr@direct.fhn.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Freeport Regional Health Care Foundation

  dba FHN

  • Family Medicine Physician
  • Freeport, IL
  • NPI 1457337016
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Freeport Memorial Hospital

  dba FHN-Memorial Hospital

  • General Acute Care Hospital
  • Freeport, IL
  • NPI 1447228788
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1003384603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611050957",
            "telephone_number": "815-395-1500",
            "fax_number": "815-395-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 N ALPINE RD STE 260",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071481",
            "telephone_number": "815-395-1500",
            "fax_number": "815-395-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "MISTY",
        "middle_name": "LYNN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle D Defilippis, APN
• Michael David Degould, DDS
• John J Deguide, M.D.
• Susan J Deguide, M.D.
• Charles Scott Dehaan, M.D.
• George W. Dehoff III, MD
• Dekalb Eye Consultants, LLC (Rockford Retina Clinic)
• Ralph Dela Cruz
• Marconi Delegero Deladisma, MD
• Kelly Rose Delehanty, PHARMD

• Family Nurse Practitioner in Rockford, IL
• Providers in Rockford, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.