Individual provider Active NPI

Rebbecca Camerer, NP

  • Family Nurse Practitioner
  • Carlinville, IL
National Provider Identifier
1467077537
Registry record updated Oct 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.021397 Issued in IL
Practice address
20733 N Broad St
Carlinville, IL 62626-3710
Phone
(217) 854-3141
NPI assigned
Jun 14, 2020
Last updated
Oct 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2022

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 209.021397 IL Primary

Addresses

Primary practice location

20733 N Broad St
Carlinville, IL 62626-3710

Mailing address

20733 N Broad St
Carlinville, IL 62626-1499
Phone (217) 854-3141

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
I20210727001709 IL Practitioner - Nurse Practitioner 2466855523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carlinville Area Hospital AssociationGroup PAC ID 9032021373, shared by 6 NPIs, 25 clinicians

Practice addresses (Care Compare)

20733 N Broad St
Carlinville, IL 62626-3710
Phone (217) 854-3141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.021397ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carlinville Area Hospital Association Current Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Carlinville Area Hospital Association CurrentSince May 25, 2022 Accepting new patients
Carlinville Area Hospital Association CurrentSince May 25, 2022 Accepting new patients
Carlinville Area Hospital Association Current Accepting new patients
Carlinville Area Hospital Association Past Accepting new patients

Locations

20733 N Broad St
Carlinville, IL 62626
Phone (217) 854-3141

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/carlin-6115abf3
  • Direct secure messaging: rebbeccacamerer@cah.allscriptsdirect.net
  • Direct secure messaging: rebbeccacamerer@sfc.allscriptsdirect.net

Organizations & group practices 6

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.

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": "1592092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1467077537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20733 N BROAD ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261499",
            "telephone_number": "217-854-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20733 N BROAD ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626263710",
            "telephone_number": "217-854-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERER",
        "first_name": "REBBECCA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-14",
        "last_updated": "2022-10-09",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.021397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlinville, IL

Sources for this page

Verify at the official NPI Registry.