Carolyn Drevlow, CFNP
Individual provider Active NPI Nurse Practitioner · Fairmont, MN
NPI 1609846989 · NPPES record last updated Jul 22, 2013
Key facts
- NPI
- 1609846989
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- R1270800 (MN)
- Practice address
- 1950 Center Creek Dr
Suite 100
Fairmont, MN 56031-3428 - Phone
- (507) 238-4968
- NPI assigned
- Jan 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Madelia Health
Practice addresses (Care Compare)
121 Drew Ave SE
Madelia, MN 56062-1841
Phone (507) 642-3255
Hospital & facility affiliations
- Madelia Health
- Mayo Clinic Health System - Fairmont
- Mayo Clinic Health System St. James
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070509000259 | MN | Practitioner - Nurse Practitioner | 2264538198 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1270800 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Specialists | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R1270800 | MN | Yes |
Addresses
Primary practice location
1950 Center Creek Dr
Suite 100
Fairmont, MN 56031-3428
Mailing address
1950 Center Creek Dr
Suite 100
Fairmont, MN 56031-3428
Phone (507) 238-4968
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 090K6DR | Other | MN | BXBS |
| 597432100 | Medicaid | MN |
Other names
- Carolyn Shoen
Other providers in Fairmont, MN
- Karmen Dather
- Laura Emily Dekok
- Julie Ann Dodds
- Lacy M Doppler
- Dr Reed E Gethmann PA
- Susan Duerksen
- Brandon Scott Dugan
- Dulcimer Medical Center PA
- Heather Duncan
- Melissa Durbin
All providers in Fairmont, MN · Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.