Individual provider Active NPI

Alicia Christine Carmack, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1639560949
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015003179 Issued in MO
Practice address
4921 Parkview PL
Div Im Medical Oncology, Ste 7a, 7B, 7C
Saint Louis, MO 63110-1032
Phone
(800) 647-2098
Fax
(314) 362-3192
NPI assigned
Feb 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2015003179 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Div Im Medical Oncology, Ste 7a, 7B, 7C
Saint Louis, MO 63110-1032

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (800) 647-2098

Other identifiers 1

IdentifierTypeStateIssuer
420020310MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150410001523 MO Practitioner - Nurse Practitioner 8325366925 Reassigns benefits to 1 organization
I20180920002661 IL Practitioner - Nurse Practitioner 8325366925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington University Physicians in Illinois IncGroup PAC ID 4789945163, 168 clinicians

Practice addresses (Care Compare)

1404 Cross St
Shiloh, IL 62269-2988
Phone (314) 362-7200

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (314) 362-7200

Hospital & facility affiliations

  • Memorial Hospital Hospital, Belleville, IL, CCN 140185
  • HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

Merit-based Incentive Payment System (MIPS)

Final score
88.01 of 100Reported as group
Quality
76.14
Promoting interoperability
99
Improvement activities
40
Cost
76.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015003179MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University Physicians in Illinois, Inc CurrentSince Jul 30, 2018 Accepting new patients
Washington University CurrentSince Nov 21, 2018 Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Jul 30, 2018 Accepting new patients
Washington University CurrentSince Nov 21, 2018 Accepting new patients
Washington University Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

5225 Mid America Plz
Ste D115
Saint Louis, MO 63129
Phone (314) 286-2500

8 Millstone Campus Dr
Saint Louis, MO 63146
Phone (314) 273-4375

660 S Euclid Ave
#C
Saint Louis, MO 63110

660 S Euclid Ave
#8056
Saint Louis, MO 63110
Phone (314) 747-4901

4921 Parkview Pl
Ste 7A7B7C
Saint Louis, MO 63110

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

4921 Parkview Pl
Ste 7A
Saint Louis, MO 63110
Phone (314) 454-8304

4240 Duncan Ave
Ste 301
Saint Louis, MO 63110

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1639560949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "800-647-2098",
            "fax_number": "314-362-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "DIV IM MEDICAL ONCOLOGY, STE 7A, 7B, 7C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "800-647-2098",
            "fax_number": "314-362-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMACK",
        "first_name": "ALICIA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015003179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420020310",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Div IM Medical Oncology, Ste 7A, 7B, 7C",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.