Active NPI
Tammy L Carlson, APRN
- Nurse Practitioner
- Rockford, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209027060
- Practice address
- 5875 E Riverside Blvd
Rockford, IL 61114-4937 - Phone
- (815) 398-9491
- Fax
- (815) 381-7498
- NPI assigned
- Feb 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 041480256 | IL | |
| Nurse Practitioner | 363L00000X | 209027060 | IL | Primary |
Addresses
Primary practice location
5875 E Riverside Blvd
Rockford, IL 61114-4937
Mailing address
PO Box 735263
Chicago, IL 60673-5263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5875 E Riverside Blvd
Rockford, IL 61114-4937
Phone (815) 398-9491
Hospital & facility affiliations
- Saint Anthony Medical Center
- Uw Health
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.02 of 100
- Quality
- 68.63
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.11
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthomidwest, PLLC | Current | Accepting new patients | |
| Orthomidwest, PLLC | Current | Accepting new patients | |
| Orthomidwest, PLLC | Current | Accepting new patients |
Locations
770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060
5875 E Riverside Blvd
Rockford, IL 61114
Phone (779) 774-1270
535 Roxbury Rd
Rockford, IL 61107
Phone (815) 387-1717
2102 Freeman Pkwy
Beloit, WI 53511
Phone (779) 221-3000
8400 Lakeview Pkwy
Ste 800
Pleasant Prairie, WI 53158
Phone (262) 455-7548
Organizations & group practices 3
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.
-
- Durable Medical Equipment & Medical Supplies
- Buffalo Grove, IL
- NPI 1043180839
-
- Durable Medical Equipment & Medical Supplies
- McHenry, IL
- NPI 1346866373
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1790739977
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1760542732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1649977786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735263",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5875 E RIVERSIDE BLVD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611144937",
"telephone_number": "815-398-9491",
"fax_number": "815-381-7498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "TAMMY",
"middle_name": "L",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-09",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "041480256",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209027060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.