Individual provider Active NPI

Elizibeth D Pittman, NP-C

  • Family Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1184085847
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006110A Issued in IN
Practice address
2330 Lynch Rd Ste 100
Evansville, IN 47711-2998
Phone
(812) 867-9800
Fax
(812) 867-4720
NPI assigned
Mar 9, 2016
Last updated
Apr 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71006110A IN Primary

Addresses

Primary practice location

2330 Lynch Rd Ste 100
Evansville, IN 47711-2998

Mailing address

291 Hillcrest Rd
Eldorado, IL 62930-3482
Phone (618) 841-1166

Other identifiers 2

IdentifierTypeStateIssuer
201352650MedicaidIN
7100395510MedicaidKY

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
I20171117000006 IL Practitioner - Nurse Practitioner 4486951639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Apg Network, LLCGroup PAC ID 6103264510, 18 clinicians

Practice addresses (Care Compare)

1181 S State Route 157
Edwardsville, IL 62025
Phone (888) 363-8333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71006110AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Institute, LLC CurrentSince Dec 1, 2023 Accepting new patients
Interventional Pain Institute, LLC CurrentSince Dec 1, 2023 Accepting new patients
Apg Network LLC CurrentSince Apr 15, 2024 Accepting new patients
Associated Physicians Group LTD Past Accepting new patients

Locations

4414 W Center Dr
Alton, IL 62002
Phone (618) 509-8454

1181 S State Route 157
Edwardsville, IL 62025
Phone (618) 288-4100

1181 S State Route 157
Ste 201B
Edwardsville, IL 62025
Phone (618) 307-9015

916 Talon Dr
O Fallon, IL 62269
Phone (618) 628-8211

916 Talon Dr
#102
O Fallon, IL 62269
Phone (618) 628-8211

916 Talon Dr
Ste 12
O Fallon, IL 62269

12 Wolf Creek Dr
Swansea, IL 62226
Phone (618) 239-9910

12 Wolf Creek Dr
Ste 200
Swansea, IL 62226
Phone (618) 239-9910

12 Wolf Creek Dr
Ste 201
Swansea, IL 62226

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1184085847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 HILLCREST RD",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629303482",
            "telephone_number": "618-841-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 LYNCH RD STE 100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477112998",
            "telephone_number": "812-867-9800",
            "fax_number": "812-867-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "ELIZIBETH",
        "middle_name": "D",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-09",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006110A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201352650",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100395510",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.