Carly Tock

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164008276 Issued in IL

Practice address

1400 W Park St
Urbana, IL 61801-2334

Phone

(217) 337-2000

NPI assigned

Feb 3, 2021

Last updated

Feb 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gibson Community Hospital AssociationGroup PAC ID 5092703124, 159 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carly.tock.p26@direct.gapho.nextgenshare.com
• Direct secure messaging: carly.tock.p5@direct.gapho.nextgenshare.com

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.

• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  Medicare reassignment Care Compare group NPD
• Gibson Community Hospital Association

  dba Gibson Specialty Pharmacy

  • Community/Retail Pharmacy
  • Gibson City, IL
  • NPI 1245105535
  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital General Surgery

  • Surgery Physician
  • Gibson City, IL
  • NPI 1780930636
  NPD

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1447842299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ORCHARD DR",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618533687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012334",
            "telephone_number": "217-337-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOCK",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164008276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Versha Kumar Thourani, M.D.
• Elizabeth L Thurman, C.R.N.A.
• Erin Tienhaara
• Victoria Ting
• Reynaldo Encarnacion Tirona, MD
• Angela Todd
• Seth Tolliver, PT
• Beverly Eri Tomita, MD
• Eric S Toone, MD
• Brianna Alexis Torres-Purmessur, PA-C

• Registered Dietitian in Urbana, IL
• Providers in Urbana, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.