Active NPI
Nathan Ackerman
- Otolaryngology Physician
- Champaign, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036157298
- Practice address
- 3101 Fields South Dr
Champaign, IL 61822-3743 - Phone
- (217) 366-1243
- NPI assigned
- Mar 25, 2016
- Last updated
- Jan 5, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 036157298 | IL | Primary |
Addresses
Primary practice location
3101 Fields South Dr
Champaign, IL 61822-3743
Mailing address
101 W University Ave
Champaign, IL 61820-3981
Phone (217) 366-1243
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nackermanmd333148@CarleHieDirect.net | Direct |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3101 Fields S Dr
Champaign, IL 61822-3743
Phone (217) 366-4000
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036157298 | IL | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christie Clinic, PLLC | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255
3101 Fields South Dr
Champaign, IL 61822
Phone (217) 366-1237
1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684
Interoperability endpoints
- nackerman414694@direct.hfhs.org
- nackermanmd333148@carlehiedirect.net
- nathan.ackerman.1@14258.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Champaign, IL
- NPI 1871523829
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Osf Heart of Mary Medical Center
- Land Ambulance
- Urbana, IL
- NPI 1093228835
Inpatient rehabilitation facility
-
dba Osf Heart of Mary Medical Center
- Psychiatric Hospital Unit
- Urbana, IL
- NPI 1649783473
Inpatient rehabilitation facility
-
dba Osf Heart of Mary Medical Center
- General Acute Care Hospital
- Urbana, IL
- NPI 1659884476
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1306208640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W UNIVERSITY AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203981",
"telephone_number": "217-366-1243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 FIELDS SOUTH DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618223743",
"telephone_number": "217-366-1243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERMAN",
"first_name": "NATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-25",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036157298",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nackermanmd333148@CarleHieDirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3101 Fields South Dr",
"city": "Champaign",
"state": "IL",
"country_code": "US",
"postal_code": "618223743",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.