Active NPI
Carrie Nussmeyer, APN, FNP-C
- Family Nurse Practitioner
- Louisville, IL
National Provider Identifier
1477914737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209014019
- Practice address
- 850 Bryant St
Louisville, IL 62858-1000 - Phone
- (618) 665-7000
- NPI assigned
- Mar 15, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209014019 | IL | Primary |
Addresses
Primary practice location
850 Bryant St
Louisville, IL 62858-1000
Mailing address
850 Bryant St
Louisville, IL 62858-1000
Phone (618) 665-7000
Other practice location 1
800 Kelly Dr SW
Clay City, IL 62824-1155
Phone (618) 662-2191
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
850 Bryant St
Louisville, IL 62858-1000
Phone (618) 665-7000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209014019 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Health and Wellness, LLC. | Current | Accepting new patients | |
| Trinity Health and Wellness, LLC. | Family | Current | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/17274/brand/1/csg/1/fhir/r4
- carrie.nussmeyer.1@17274.direct.athenahealth.com
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Trinity Health and Wellness LLC | Rural health clinic | 5% Or Greater Direct Ownership Interest (33.33%) Corporate Officer Corporate Director W-2 Managing Employee |
Mar 1, 2019 Mar 1, 2019 Mar 1, 2019 Mar 1, 2019 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Health Clinic/Center
- Louisville, IL
- NPI 1356857981
5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee
Organizations & group practices 2
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.
-
- Rural Health Clinic/Center
- Louisville, IL
- NPI 1134750243
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Flora, IL
- NPI 1184655136
-
- General Acute Care Hospital
- Mount Vernon, IL
- NPI 1609897339
-
- Critical Access Hospital
- Salem, IL
- NPI 1295739548
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
-
- General Acute Care Hospital
- Effingham, IL
- NPI 1306800602
-
- Clinic/Center
- Effingham, IL
- NPI 1881214104
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548028800000",
"number": "1477914737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 BRYANT ST",
"city": "LOUISVILLE",
"state": "IL",
"postal_code": "628581000",
"telephone_number": "618-665-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 BRYANT ST",
"city": "LOUISVILLE",
"state": "IL",
"postal_code": "628581000",
"telephone_number": "618-665-7000"
}
],
"practiceLocations": [
{
"address_1": "800 Kelly Dr SW",
"address_purpose": "LOCATION",
"city": "Clay City",
"state": "IL",
"postal_code": "628241155",
"country_code": "US",
"telephone_number": "618-662-2191",
"fax_number": "618-662-3077",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NUSSMEYER",
"first_name": "CARRIE",
"credential": "APN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-15",
"last_updated": "2019-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209014019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.