Carly Dearth

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209022620 Issued in IL

Practice address

5521 W Lincoln Hwy
Crown Point, IN 46307-1097

Phone

(219) 769-1362

NPI assigned

May 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IN, IL, NC, OH4 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 4

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians

Midwest Express Care 4 LLCGroup PAC ID 4284909615, 64 clinicians

Eventus Ecs, IncGroup PAC ID 2163969650, 243 clinicians

Eventus WH Southeast, LLCGroup PAC ID 5496294456, 241 clinicians

Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Eventus Ecs, Inc

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1073353496

  OH

  Medicare reassignment Care Compare group NPD
• Extended Care Specialists, Inc

  • Adult Medicine Physician
  • Merrillville, IN
  • NPI 1134146079

  Family, OH

  Medicare reassignment Care Compare group NPD
• Eventus WH Southeast, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Charlotte, NC
  • NPI 1487494811
  Medicare reassignment Care Compare group NPD
• Eventus Wholehealth, PLLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1548759392
  Medicare reassignment Care Compare group NPD
• Midwest Express Care 4 LLC

  • Urgent Care Clinic/Center
  • Hammond, IN
  • NPI 1629502810
  Medicare reassignment Care Compare group
• Eventus Wholehealth Midwest Inc

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1386252757

  OH

  Medicare reassignment NPD
• Nwi Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Munster, IN
  • NPI 1043596703
  Medicare reassignment NPD
• Eventus Ecs - Kentucky, PLLC

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1396563276

  IN

  Medicare reassignment NPD
• Eventus Value Care, LLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1013680503
  Medicare reassignment NPD
• Eventus WH Midwest Care, LLC

  • Nurse Practitioner
  • Concord, NC
  • NPI 1588481717

  IN

  Medicare reassignment NPD
• Midwest Express Care 2, Inc

  • Urgent Care Clinic/Center
  • Willowbrook, IL
  • NPI 1548692890
  Medicare reassignment NPD
• Midwest Express Care, Inc

  • Urgent Care Clinic/Center
  • Schererville, IN
  • NPI 1942642848
  Medicare reassignment

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1689249294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7028 E 110TH LN",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 W LINCOLN HWY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071097",
            "telephone_number": "219-769-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARTH",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.uchicagomedicine.org",
            "affiliation": "N",
            "address_1": "5656 S Maryland Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.midwestexpressclinic.com",
            "affiliation": "N",
            "endpointDescription": "url",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "url",
            "address_1": "5521 W Lincoln Hwy",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463071097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Trevaughn Davis-Neal, LCSW
• Amari Euniece Davis
• Taylor Davitt
• Jordan De Laurentis, LSW
• Tuwanda Dean, RBT
• Debi'S Family Counseling, Inc.
• Sharilynn R Deboer, PT
• Laurie Deeb, NP-C
• Michael Deek
• Jalyn N Deery, NP

• Family Nurse Practitioner in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.

Verify at the official NPI Registry.