Antonia Jacqueline Abrahamsen, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Bloomington, IL
NPI 1720532005 · NPPES record last updated Aug 4, 2016
Key facts
- NPI
- 1720532005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209014663 (IL)
- Practice address
- 2009 E Oakland Ave
Bloomington, IL 61701-5756 - Phone
- (309) 287-8737
- NPI assigned
- Aug 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Orthopedic and Shoulder Center S C
Practice addresses (Care Compare)
2200 Fort Jesse Rd
Suite 250
Normal, IL 61761-6290
Phone (309) 888-9800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161024000916 | IL | Practitioner - Nurse Practitioner | 9335427574 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209014663 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic & Shoulder Center, S.C. | Current |
Accepting new patients |
Locations
2200 Fort Jesse Rd
Ste 250
Normal, IL 61761
Phone (309) 268-0000
Interoperability endpoints
- aabrahamsenaprn322908@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209014663 | IL | Yes |
Addresses
Primary practice location
2009 E Oakland Ave
Bloomington, IL 61701-5756
Mailing address
2009 E Oakland Ave
Bloomington, IL 61701-5756
Other providers in Bloomington, IL
- A Balanced Approach to Wellness PLLC
- A Caring Touch of McLean County, Inc.
- Whitney Aaron
- Peter S Abadeer
- Gil B Abelita
- Eric Abreu
- Accelerated Rehabiliation Centers LTD
- Accelerated Rehabilitation Centers, LTD
- Access Dental of Bloomington PLLC
- Accident & Sports Clinic SC
All providers in Bloomington, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.