Active NPI
Carol J Lantz, APN
- Family Nurse Practitioner
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209017355
- Practice address
- 3132 Old Jacksonville Rd
Springfield, IL 62704 - Phone
- (217) 588-2600
- Fax
- (217) 862-0904
- NPI assigned
- Jan 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209017355 | IL | Primary |
Addresses
Primary practice location
3132 Old Jacksonville Rd
Springfield, IL 62704
Mailing address
PO Box 3428
Springfield, IL 62708-3428
Phone (217) 588-2624
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041361033 | Other | IL | RN LICNESE |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180504000023 | IL | Practitioner - Nurse Practitioner | 5496019168 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3132 Old Jacksonville Rd
Suite 200
Springfield, IL 62704-7401
Phone (217) 862-0800
Hospital & facility affiliations
- Memorial Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.44 of 100
- Quality
- 71.79
- Promoting interoperability
- 77
- Improvement activities
- 40
- Cost
- 75.71
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209017355 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Physician Services | Current | Accepting new patients | |
| Memorial Physician Services | Current | Accepting new patients | |
| Memorial Physician Services | Current | Accepting new patients | |
| Family Medical Center of Chatham, LLC | Current | Accepting new patients |
Locations
101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487
3132 Old Jacksonville Rd
Ste 200
Springfield, IL 62704
Phone (217) 862-0800
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Chatham, IL
- NPI 1992956528
-
- Family Medicine Physician
- Springfield, IL
- NPI 1275065906
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1417922964
-
- Rural Health Clinic/Center
- Jacksonville, IL
- NPI 1528741147
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533859200000",
"number": "1114435559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3428",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627083428",
"telephone_number": "217-588-2624",
"fax_number": "217-757-2021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3132 OLD JACKSONVILLE RD",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "62704",
"telephone_number": "217-588-2600",
"fax_number": "217-862-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANTZ",
"first_name": "CAROL",
"middle_name": "J",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-19",
"last_updated": "2018-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209017355",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICNESE",
"identifier": "041361033",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.