Roseann Cecilina Iverson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277000696 Issued in IL

Practice address

2000 Lake Ave
Woodstock, IL 60098-7401

Phone

(815) 337-7100

Fax

(815) 337-4793

NPI assigned

Apr 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health System Corp Hospital, Janesville, WI, CCN 520066
• Mercy Harvard Hospital Hospital, Harvard, IL, CCN 141335
• Mercyhealth Hospital & Physician Clinic-Crystal la Hospital, Crystal Lake, IL, CCN 140308
• Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: riverson104307@direct.mhemail.org

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.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603

  IL

  Medicare reassignment Care Compare group NPD
• Mercy Harvard Hospital Inc

  • Critical Access Hospital
  • Harvard, IL
  • NPI 1427001445
  Medicare reassignment NPD
• Mercy Harvard Hospital Inc

  • Skilled Nursing Facility
  • Harvard, IL
  • NPI 1124195557
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Crystal Lake Hospital and Medical Center Inc

  • General Acute Care Hospital
  • Crystal Lake, IL
  • NPI 1023754371
  Care Compare affiliation
• Mercy Harvard Hospital Inc

  • Critical Access Hospital
  • Harvard, IL
  • NPI 1427001445
  Care Compare affiliation
• Northern Illinois Medical Center

  • General Acute Care Hospital
  • McHenry, IL
  • NPI 1982611281
  Care Compare affiliation
• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  Care Compare affiliation

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1386099208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 LAKE AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987401",
            "telephone_number": "815-337-7100",
            "fax_number": "815-337-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 LAKE AVE",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987401",
            "telephone_number": "815-337-7100",
            "fax_number": "815-337-4793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 S. Route 31",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600148190",
            "country_code": "US",
            "telephone_number": "779-220-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1095 Pingree Rd",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600141725",
            "country_code": "US",
            "telephone_number": "815-459-6655",
            "fax_number": "847-658-9922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "ROSEANN",
        "middle_name": "CECILINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014218",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FULL PRACTICE AUTHORITY",
            "identifier": "277000696",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Illinois Cancer Specialists
• Independence Health & Therapy
• Independence Health & Therapy
• Independence Health & Therapy
• Inner Balance Mental Health and Wellness, PLLC
• Cheryl Jackson, O.D.
• David D Janes, D.D.S.
• Christine Michelle Janikowski, O.D.
• Teresa Louise Janowski, DC
• Amy Jeris, M.S.

• Family Nurse Practitioner in Woodstock, IL
• Providers in Woodstock, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.

Verify at the official NPI Registry.