Individual provider Active NPI

Carrie McCormick, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1356903637
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209020123 Issued in IL
Practice address
3225 Hedley Rd
Springfield, IL 62711-6248
Phone
(217) 726-7300
Fax
(217) 726-5989
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.385417 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209020123 IL Primary

Addresses

Primary practice location

3225 Hedley Rd
Springfield, IL 62711-6248

Mailing address

3225 Hedley Rd
Springfield, IL 62711-6248
Phone (217) 726-7300

Other identifiers 1

IdentifierTypeStateIssuer
041.385417OtherILRN LICENSE

Other names 1

  • Carrie Cook Former name

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
I20191015000180 IL Practitioner - Nurse Practitioner 6901137470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Practice addresses (Care Compare)

3225 Hedley Rd
Springfield, IL 62711-6248
Phone (217) 726-7300

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041.385417ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Physician Services CurrentSince Sep 26, 2019 Accepting new patients
Memorial Physician Services CurrentSince Sep 26, 2019 Accepting new patients
Memorial Physician Services Current Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients
Memorial Health Partners Current Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

3225 Hedley Rd
Springfield, IL 62711
Phone (217) 726-6700

Interoperability endpoints

  • Direct secure messaging: carriemccormick@memorial.allscriptsdirect.net
  • Direct secure messaging: carriemccormick@sfc.allscriptsdirect.net

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1356903637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 HEDLEY RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116248",
            "telephone_number": "217-726-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 HEDLEY RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116248",
            "telephone_number": "217-726-7300",
            "fax_number": "217-726-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "CARRIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.385417",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209020123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041.385417",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "COOK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.