Individual provider Active NPI

Teresa Boyle, APRN

  • Nurse Practitioner
  • Normal, IL
National Provider Identifier
1467228049
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.028903 Issued in IL
Practice address
407 E Vernon Ave
Normal, IL 61761-3813
Phone
(309) 451-8500
NPI assigned
Nov 27, 2023
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.028903 IL Primary

Addresses

Primary practice location

407 E Vernon Ave
Normal, IL 61761-3813

Mailing address

611 W Park St
Fapc
Urbana, IL 61801-2500
Phone (217) 902-5292

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
I20231219002143 IL Practitioner - Nurse Practitioner 5698125557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

407 E Vernon Ave
Normal, IL 61761-3813
Phone (309) 451-8500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.028903ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group CurrentSince Oct 4, 2025 Accepting new patients
Carle West Physician Group Inc CurrentSince Dec 11, 2023 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

407 E Vernon Ave
Normal, IL 61761
Phone (309) 451-2231

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: tboylern321632@carlehiedirect.net

Organizations & group practices 3

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": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1467228049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-902-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E VERNON AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613813",
            "telephone_number": "309-451-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "TERESA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.028903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.