NPIMap

Individual provider Active NPI

Carrie Anne Green, APN

  • Family Nurse Practitioner
  • Monmouth, IL
National Provider Identifier
1285193441
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209019054 Issued in IL
Practice address
1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone
(309) 734-1414
Fax
(309) 734-0323
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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 209019054 IL Primary

Addresses

Primary practice location

1000 W Harlem Ave
Monmouth, IL 61462-1007

Mailing address

1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone (309) 734-1414

Other names 1

  • Carrie Anne Cross Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190417000435 IL Practitioner - Nurse Practitioner 1153662333 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Healthcare System 94 clinicians
St Mary Medical Center 52 clinicians

Practice addresses (Care Compare)

1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone (309) 734-3141

104 S Broadway St
Knoxville, IL 61448
Phone (309) 289-2335

904 E Main St
Osf Healthcare Medical Group Knoxville
Knoxville, IL 61448-1539
Phone (309) 289-2335

Hospital & facility affiliations

  • Western Ill Home HLTH Care in Home health agency, Monmouth, IL, CCN 147204
  • Osf Home Health-Western Region Home health agency, Galesburg, IL, CCN 147430
  • Osf Holy Family Medical Center Hospital, Monmouth, IL, CCN 141318
  • St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209019054ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Medical Center Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
St Mary Medical Center Nurse Practitioner CurrentSince Dec 1, 2022 Accepting new patients
Osf Healthcare System CurrentSince Mar 28, 2019 Accepting new patients
Osf Healthcare System CurrentSince Mar 28, 2019 Accepting new patients
St Mary Medical Center CurrentSince Dec 1, 2022 Accepting new patients
Osf Healthcare System Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Apr 22, 2023 Accepting new patients
St Mary Medical Center Past Accepting new patients

Locations

695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-8131

904 E Main St
Knoxville, IL 61448
Phone (309) 289-2335

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

235 E Penn Ave
Roseville, IL 61473
Phone (309) 426-2128

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 4

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1285193441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W HARLEM AVE",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621007",
            "telephone_number": "309-734-1414",
            "fax_number": "309-734-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W HARLEM AVE",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621007",
            "telephone_number": "309-734-1414",
            "fax_number": "309-734-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CARRIE",
        "middle_name": "ANNE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "CROSS",
            "middle_name": "ANNE",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monmouth, IL

Sources for this page

Verify at the official NPI Registry.