Individual provider Active NPI

Lisa Roxworthy, APRN, CNP

  • Nurse Practitioner
  • Dekalb, IL
National Provider Identifier
1174209746
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209027677 Issued in IL
Practice address
1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone
(815) 766-7334
Fax
(815) 766-9768
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209027677 IL Primary

Addresses

Primary practice location

1 Kish Hospital Dr
Dekalb, IL 60115-9602

Mailing address

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 766-7334

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231101003098 IL Practitioner - Nurse Practitioner 6204282809 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361
Phone (847) 437-5500

875 S Route 31
Crystal Lake, IL 60014-8190
Phone (779) 220-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP Current Accepting new patients
Rockford Health Physicians CurrentSince May 1, 2025 Accepting new patients
Cepamerica Illinois LLP CurrentSince Oct 23, 2023 Accepting new patients
Mercy Health System Corporation CurrentSince May 1, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince May 1, 2025 Accepting new patients
Cepamerica Illinois LLP CurrentSince Oct 23, 2023 Accepting new patients
Mercy Health System Corporation Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

901 Grant St
Harvard, IL 60033
Phone (815) 943-5431

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

Organizations & group practices 7

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.

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1174209746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-766-7334",
            "fax_number": "815-766-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-766-7334",
            "fax_number": "815-766-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROXWORTHY",
        "first_name": "LISA",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

Verify at the official NPI Registry.