Individual provider Active NPI

Carmalita Lewis-Buchanan, APN, FNP-BC

  • Nurse Practitioner
  • Harvey, IL
National Provider Identifier
1649799404
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-015131 Issued in IL
Practice address
One Ingalls Drive
Harvey, IL 60426-3558
Phone
(708) 333-2300
NPI assigned
Sep 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-015131 IL Primary

Addresses

Primary practice location

One Ingalls Drive
Harvey, IL 60426-3558

Mailing address

646 E. 156TH Place
South Holland, IL 60473-1515
Phone (708) 331-4542

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
I20171102000000 IL Practitioner - Nurse Practitioner 1052677366 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-015131ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Illinois PC CurrentSince Aug 22, 2022 Accepting new patients

Locations

10137 Grand Ave
Franklin Park, IL 60131
Phone (847) 451-7590

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1649799404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 E. 156TH PLACE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731515",
            "telephone_number": "708-331-4542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE INGALLS DRIVE",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263558",
            "telephone_number": "708-333-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS-BUCHANAN",
        "first_name": "CARMALITA",
        "name_prefix": "Mrs.",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-015131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, IL

Sources for this page

Verify at the official NPI Registry.