Individual provider Active NPI

Joseph Patrick Carney, FNP-C

  • Nurse Practitioner
  • Kankakee, IL
National Provider Identifier
1497264865
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-016590 Issued in IL
Practice address
350 N Wall St
Kankakee, IL 60901-2901
Phone
(815) 725-7500
NPI assigned
Sep 28, 2017
Last updated
Nov 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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 209-016590 IL Primary

Addresses

Primary practice location

350 N Wall St
Kankakee, IL 60901-2901

Mailing address

548 Diversatech Dr S
Manteno, IL 60950-3561
Phone (815) 325-5785

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
I20171205003487 IL Practitioner - Nurse Practitioner 5597022293 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Group-Emergency Physicians an Illinois Concern SCGroup PAC ID 0345212841, 10 clinicians
Riverside Emergency Physicians LLCGroup PAC ID 6204294119, 35 clinicians

Practice addresses (Care Compare)

150 W High St
Morris, IL 60450-1463
Phone (815) 942-2129

350 N Wall St
Kankakee, IL 60901-2901
Phone (815) 933-1671

Merit-based Incentive Payment System (MIPS)

Final score
99.91 of 100Reported as group
Quality
96.37
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.25 of 100Reported as group
Quality
72.26
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-016590ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Group-Emergency Physicians an Illinois Concern S.C. CurrentSince Jan 1, 2022 Accepting new patients
Riverside Emergency Physicians, LLC CurrentSince Aug 10, 2023 Accepting new patients
Lockport Express Medical Group, Inc. CurrentSince Sep 1, 2020 Accepting new patients

Locations

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

16221 W 159th St
Lockport, IL 60441
Phone (815) 588-1111

150 W High St
Morris, IL 60450
Phone (815) 942-2129

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.

NPI Registry JSON

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1497264865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 DIVERSATECH DR S",
            "city": "MANTENO",
            "state": "IL",
            "postal_code": "609503561",
            "telephone_number": "815-325-5785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012901",
            "telephone_number": "815-725-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEY",
        "first_name": "JOSEPH",
        "middle_name": "PATRICK",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-016590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.