Carly Worden, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

10299-33 Issued in WI

Practice address

2707 15TH PL
Kenosha, WI 53140-4947

Phone

(262) 551-2700

NPI assigned

Sep 9, 2020

Last updated

Jan 4, 2024By 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 2

Addresses

Other identifiers 1

Other names 1

• Carly Pickos Former name

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WI

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpickos186721@direct.myadvocateaurora.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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment Care Compare group NPD
• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment NPD
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • St Francis, WI
  • NPI 1003861188
  Medicare reassignment NPD
• Zenith Healthcare SC

  • Cardiovascular Disease Physician
  • Kenosha, WI
  • NPI 1043610280
  Medicare reassignment NPD
• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Lakeshore Medical Clinic LTD

  dba LMC Bucyrus Medical

  • Family Medicine Physician
  • South Milwaukee, WI
  • NPI 1174851893
  NPD
• Phoenixc Healthcare, SC

  • Clinical Cardiac Electrophysiology Physician
  • Kenosha, WI
  • NPI 1821591710
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)

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

• Aurora Health Care Southern Lakes, Inc.

  • General Acute Care Hospital
  • Kenosha, WI
  • NPI 1225156888
  Care Compare affiliation

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1053926949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-551-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 15TH PL",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404947",
            "telephone_number": "262-551-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORDEN",
        "first_name": "CARLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "10299-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10299-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100104069",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "endpointDescription": "EPIC EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EPIC",
            "address_1": "2707 15th Pl",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531404947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpickos186721@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2707 15th Pl",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531404947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2707 15th Pl",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531404947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "PICKOS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Womens Wellness
• Andrea A Wood, PHARMD
• Brenda Joyce Woodhull, RN,CDE
• Woodstock Health and Rehab
• Woodstock Health Care LLC (Waters Edge Rehabilitation and Care Center)
• Ashley Heather Worley, SLP
• Sierra N Worob, LCSW
• Worth Counseling
• Catherine Ann Woznicki, M.S.
• Jane Wright, DDS, MS

• Nurse Practitioner in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.