Individual provider Active NPI

Patricia L Calvin, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Winfield, IL
National Provider Identifier
1538330477
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209006968 Issued in IL
Practice address
27W411 Providence LN
Winfield, IL 60190-1074
Phone
(312) 953-9233
Fax
(630) 653-1277
NPI assigned
Mar 19, 2008
Last updated
Sep 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209006968 IL
Family Nurse Practitioner 363LF0000X 209006968 IL Primary

Addresses

Primary practice location

27W411 Providence LN
Winfield, IL 60190-1074

Mailing address

27W411 Providence LN
Winfield, IL 60190-1074
Phone (312) 953-9233

Other identifiers 1

IdentifierTypeStateIssuer
209006968OtherILADVANCE PRACTICE NURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical LLC Nurse Practitioner Past Accepting new patients
Paragon Clinical Midwest, LLC Nurse Practitioner Past Accepting new patients

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, 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": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1538330477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27W411 PROVIDENCE LN",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901074",
            "telephone_number": "312-953-9233",
            "fax_number": "630-653-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27W411 PROVIDENCE LN",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901074",
            "telephone_number": "312-953-9233",
            "fax_number": "630-653-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALVIN",
        "first_name": "PATRICIA",
        "middle_name": "L",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006968",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209006968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCE PRACTICE NURSE",
            "identifier": "209006968",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.