Individual provider Active NPI

Carolyn Ann Calhoun, APN, CNM

  • Advanced Practice Midwife
  • Peoria, IL
National Provider Identifier
1811326317
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209.010720 Issued in IL
Practice address
2321 N Wisconsin Ave
Peoria, IL 61603-5613
Phone
(309) 680-7600
Fax
(309) 681-8443
NPI assigned
Nov 5, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209.010720 IL Primary

Addresses

Primary practice location

2321 N Wisconsin Ave
Peoria, IL 61603-5613

Mailing address

2214 N University St
Peoria, IL 61604-3221
Phone (309) 680-7600

Other identifiers 1

IdentifierTypeStateIssuer
5433001MedicaidIL

Other names 1

  • Mrs. Carolyn Ann Strom Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140313001135 IL Practitioner - Certified Nurse Midwife (CNM) 3375773336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2900 N Knoxville Ave
Peoria, IL 61603-1748
Phone (309) 308-3310

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

9128 N Lindbergh Dr
Osf Medical Group Obstetrics and Gynecology
Peoria, IL 61615-1422
Phone (309) 308-3310

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209.010720ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 14, 2024 Accepting new patients

Locations

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

2806 N Knoxville Ave
Peoria, IL 61604
Phone (309) 655-6961

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

9128 N Lindbergh Dr
Peoria, IL 61615
Phone (309) 308-3310

Organizations & group practices 2

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": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811326317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043221",
            "telephone_number": "309-680-7600",
            "fax_number": "309-681-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 N WISCONSIN AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616035613",
            "telephone_number": "309-680-7600",
            "fax_number": "309-681-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209.010720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5433001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "STROM",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "APN, CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.