Individual provider Active NPI

Carolyn Zhang, APRN, FNP-C

  • Family Nurse Practitioner
  • Champaign, IL
National Provider Identifier
1740034768
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209030384 Issued in IL
Practice address
1907 W Springfield Ave Ste B
Champaign, IL 61821-3098
Phone
(217) 530-0200
NPI assigned
Apr 16, 2024
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209030384 IL Primary

Addresses

Primary practice location

1907 W Springfield Ave Ste B
Champaign, IL 61821-3098

Mailing address

1907 W Springfield Ave Ste B
Champaign, IL 61821-3098

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
I20241017003663 IL Practitioner - Nurse Practitioner 5395277198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chambana Urgent Care and Walk in ClinicGroup PAC ID 5395196372, 5 clinicians

Practice addresses (Care Compare)

1907 W Springfield Ave
Suite B
Champaign, IL 61821-3098
Phone (732) 822-8483

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209030384ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chambana Urgent Care and Walk in Clinic CurrentSince Oct 1, 2024 Accepting new patients

Locations

1907 W Springfield Ave
Ste B
Champaign, IL 61821
Phone (217) 898-8393

Interoperability endpoints

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1740034768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 W SPRINGFIELD AVE STE B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618213098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W SPRINGFIELD AVE STE B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618213098",
            "telephone_number": "217-530-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "CAROLYN",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209030384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.