Carrie Goodrum Alexander, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Lincoln, IL
NPI 1760972715 · NPPES record last updated May 15, 2018
Key facts
- NPI
- 1760972715
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209017097 (IL)
- Practice address
- 1096 1350TH St
Lincoln, IL 62656-5094 - Phone
- (217) 735-5581
- NPI assigned
- May 15, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 25
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint James Hospital
Osf Multi-Specialty Group
Practice addresses (Care Compare)
111 Spring St
FL 4
Streator, IL 61364-3332
Phone (815) 672-4587
1765 Bradford LN
Normal, IL 61761-1296
Phone (309) 661-2400
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828
Hospital & facility affiliations
- St Joseph Medical Center
- Osf Saint Elizabeth MDL Ctr
- Saint James Hospital
- Northwestern Medicine Central Dupage Hospital
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 |
|---|---|---|---|---|
| I20180814000318 | IL | Practitioner - Nurse Practitioner | 6507115201 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209017097 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint James Hospital | Current |
Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Saint James Hospital | Current |
Accepting new patients | |
| Advocate Health & Hospitals Corp. | Current |
Accepting new patients | |
| Carle West Physician Group Inc | Current |
Accepting new patients | |
| Saint James Hospital | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current |
Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Saint James Hospital | Current |
Accepting new patients | |
| Mycare Express Care Inc | Current |
Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Cardinal Medical Group, LTD. | Past | Accepting new patients | |
| Saint James Hospital | Past | Accepting new patients | |
| Memorial Expresscare, LLC | Past | Accepting new patients |
Locations
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
1404 Eastland Dr
Ste 103
Bloomington, IL 61701
Phone (309) 319-2393
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
2200 Fort Jesse Rd
Ste 100
Normal, IL 61761
Phone (309) 661-6280
1765 Bradford Ln
Normal, IL 61761
Phone (309) 661-2400
124 SW Adams St
Fl 2
Peoria, IL 61602
Phone (309) 655-2850
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850
2500 W Reynolds St
Ste 207
Pontiac, IL 61764
Phone (815) 579-9002
2500 W Reynolds St
Ste 205
Pontiac, IL 61764
2500 W Reynolds St
Ste 203
Pontiac, IL 61764
Phone (815) 844-2001
2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828
2500 W Reynolds St
Ste 206
Pontiac, IL 61764
Interoperability endpoints
- carrie.alexander.1@26072.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209017097 | IL | Yes |
Addresses
Primary practice location
1096 1350TH St
Lincoln, IL 62656-5094
Mailing address
1096 1350TH St
Lincoln, IL 62656-5094
Other providers in Lincoln, IL
- Abraham Lincoln Memorial Hospital
- Abraham Lincoln Memorial Hospital
- Brittany N Ackman
- Frank Adubato
- Aegis Group Practice LLC
- Darwin J Allen
- Alpha Omega Consulting, Inc.
- Elise Marie Anderson
- Arc at Lincoln LLC
- Arc at Lincoln LLC
All providers in Lincoln, 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 May 15, 2018. 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.