Individual provider Active NPI

Amy Nichole Dinga, FNP

  • Nurse Practitioner
  • Carbondale, IL
National Provider Identifier
1285035436
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209011977 Issued in IL
Practice address
1400 Financial Park
Carbondale, IL 62902-7537
Phone
(618) 351-9140
Fax
(618) 351-9143
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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 209011977 IL Primary

Addresses

Primary practice location

1400 Financial Park
Carbondale, IL 62902-7537

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adinga14010@sih.direct-ci.com

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
I20160406002485 IL Practitioner - Nurse Practitioner 2668770645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 Financial Park Dr
Carbondale, IL 62901
Phone (618) 351-9140

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209011977ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Mar 14, 2016 Accepting new patients

Locations

405 W Jackson St
Carbondale, IL 62901

1400 Financial Park
Carbondale, IL 62902
Phone (618) 351-9140

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

Interoperability endpoints

  • Direct secure messaging: adinga14010@sih.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1285035436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FINANCIAL PARK",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629027537",
            "telephone_number": "618-351-9140",
            "fax_number": "618-351-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINGA",
        "first_name": "AMY",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209011977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adinga14010@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "1400 Financial Park",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629027537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.