Timyra Lee Carter, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Danville, IL
NPI 1134820954 · NPPES record last updated Mar 17, 2023
Key facts
- NPI
- 1134820954
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209026868 (IL)
- Practice address
- 1104 Lorraine St
Danville, IL 61832-3437 - Phone
- (217) 597-1281
- NPI assigned
- Mar 17, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231226000857 | IL | Practitioner - Nurse Practitioner | 7416307913 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitae Health Medical Illinois, PLLC | Current |
Accepting new patients | |
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients |
Locations
303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347
801 N Logan Ave
Danville, IL 61832
Phone (217) 443-3106
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209026868 | IL | Yes |
Addresses
Primary practice location
1104 Lorraine St
Danville, IL 61832-3437
Mailing address
1104 Lorraine St
Danville, IL 61832-3437
Phone (217) 597-1281
Other providers in Danville, IL
- Carle Health Care Incorporated
- Carle Surgicenter
- Laura Alene Carlson
- Nicole D Carter
- Robin Carter
- Catholic Chariteis of the Diocese of Peoria
- Tory Ceader
- Center for Children'S Services
- Central Illinois Family Practice
- Central Illinois Natural Health Clinic, LTD.
All providers in Danville, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.