Carli Ann Light, APRN, CNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

209028999 Issued in IL

Practice address

401 N Main St
Roanoke, IL 61561-7585

Phone

(309) 923-2661

NPI assigned

Feb 21, 2024

Last updated

Oct 25, 2024By 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 2

Addresses

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

Specialty

Nurse Practitioner

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment Care Compare group NPD
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Ottawa, IL
  • NPI 1306971080
  Medicare reassignment NPD
• Board of Trustees of the University of Illinois

  dba Medical Service Plan at Peoria

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Healthcare - Medical Group (Non-RHC Billing)

  • Family Medicine Physician
  • Marseilles, IL
  • NPI 1558088203
  NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  NPD (past)
• Saint James Hospital

  dba OSF Healthcare - Medical Group - Pontiac

  • Rural Health Clinic/Center
  • Pontiac, IL
  • NPI 1447976113
  NPD (past)

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1508622275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "ROANOKE",
            "state": "IL",
            "postal_code": "615617585",
            "telephone_number": "309-923-2661",
            "fax_number": "309-923-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "ROANOKE",
            "state": "IL",
            "postal_code": "615617585",
            "telephone_number": "309-923-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "CARLI",
        "middle_name": "ANN",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209028999",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "209.028999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Finegan, APRN
• Petra Flores, APRN, FNP-C
• Victoria Gorfin, PA-C
• Renee Elizabeth Hemp, APRN
• Jennifer Brooke Jensen, FNP
• McKenzie K Mangun, PA-C
• Michael D. Meier, DMD
• Jodi Renee Meyer, M.S., CCC-SLP/L
• Alyssa Morris, FNP-BC
• Roanoke Benson Cus Dist 60

• Pediatric Nurse Practitioner in Roanoke, IL
• Providers in Roanoke, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.