Individual provider Active NPI

Sara E Smith, APN

  • Women's Health Nurse Practitioner
  • Freeport, IL
National Provider Identifier
1649471434
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
Practice address
3103 W Kunkle Blvd
Freeport, IL 61032-6922
Phone
(815) 233-0999
Fax
(815) 233-7255
NPI assigned
May 30, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X IL Primary

Addresses

Primary practice location

3103 W Kunkle Blvd
Freeport, IL 61032-6922

Mailing address

3103 W Kunkle Blvd
Freeport, IL 61032-6922
Phone (815) 233-0999

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
I20080609000756 IL Practitioner - Nurse Practitioner 6709956303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1010 Fairway Dr
Freeport, IL 61032-6600
Phone (815) 599-7421

1120 Healthcare Dr
Mount Carroll, IL 61053-1461
Phone (815) 244-4181

600 N Rush St
Stockton, IL 61085-1010
Phone (815) 947-3211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.84 of 100Reported as group
Quality
75.22
Promoting interoperability
92
Improvement activities
40
Cost
73.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center CurrentSince Dec 29, 2016 Accepting new patients
CGH Medical Center CurrentSince Dec 29, 2016 Accepting new patients
CGH Medical Center Current Accepting new patients

Locations

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649471434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 W KUNKLE BLVD",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326922",
            "telephone_number": "815-233-0999",
            "fax_number": "815-233-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 W KUNKLE BLVD",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326922",
            "telephone_number": "815-233-0999",
            "fax_number": "815-233-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SARA",
        "middle_name": "E",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

Verify at the official NPI Registry.