Carrie Cullick, MSN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.014421 Issued in IL

Practice address

121 Robert P Weidling Dr
Wilmington, IL 60481-1679

Phone

(815) 726-2200

NPI assigned

Jul 27, 2016

Last updated

Jul 27, 2016By the provider in NPPES

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

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint James HospitalGroup PAC ID 0648187252, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint James Hospital Hospital, Pontiac, IL, CCN 140161
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• Morris Hospital & Healthcare Centers Hospital, Morris, IL, CCN 140101

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• Saint James Hospital

  dba Saint James Hospital - Multiple Hospital Departments

  • Anesthesiology Physician
  • Pontiac, IL
  • NPI 1790735421
  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Saint James Hospital

  dba OSF Healthcare - Medical Group - Roanoke

  • Rural Health Clinic/Center
  • Roanoke, IL
  • NPI 1164138848
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Saint James Hospital

  dba OSF Medical Group - Cullom

  • Rural Health Clinic/Center
  • Cullom, IL
  • NPI 1790712701
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Morris Hospital

  dba Morris Hospital & Healthcare Centers

  • General Acute Care Hospital
  • Morris, IL
  • NPI 1649370057
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• Saint James Hospital

  dba Osf Saint James-John W Albrecht Medical Center

  • General Acute Care Hospital
  • Pontiac, IL
  • NPI 1407808090
  Care Compare affiliation

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1770036584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 ROBERT P WEIDLING DR",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604811679",
            "telephone_number": "815-726-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 ROBERT P WEIDLING DR",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604811679",
            "telephone_number": "815-726-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLICK",
        "first_name": "CARRIE",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.014421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Anthony Carollo, D.D.S.
• Larissa Chaidez
• Sanjay Chatrath, DO
• CJ Dziuban, LCSW, LLC
• Crest Medical Group LLC
• Chester Joseph Dziuban, LCSW
• Elizabeth M Eaton, LCPC
• Embassy Care Center
• Embassy Holdings LLC (Embassy Health Care Center)
• Fitzsimmons Chiropractic P.C.

• Family Nurse Practitioner in Wilmington, IL
• Providers in Wilmington, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.