Rick Eugene Carlson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209010193 Issued in IL

Practice address

400 Riverside Dr Ste 2100
Bourbonnais, IL 60914-5004

Phone

(815) 935-2784

Fax

(815) 935-5687

NPI assigned

Feb 4, 2013

Last updated

Feb 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rcarlson6848@direct.riversidehealthcare.net

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.

• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  Medicare reassignment Care Compare group NPD
• Riverside Health System

  dba Psychiatric Associates

  • Psychiatry Physician
  • Kankakee, IL
  • NPI 1336354430
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1821337437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERSIDE DR STE 2100",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145004",
            "telephone_number": "815-935-2784",
            "fax_number": "815-935-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RIVERSIDE DR STE 2100",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145004",
            "telephone_number": "815-935-2784",
            "fax_number": "815-935-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "RICK",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-04",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarlson6848@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "400 Riverside Dr Ste 2100",
            "city": "Bourbonnais",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609145004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Calynn Toberman, PLLC
• Megan Ann Campbell-Degedeh
• Tara A Campo, NP-C
• Diana Cardenas
• Jo Ellen Carl, LCPC
• Carrie Spitalli, Psy.D., P.C.
• Isaac Casas, RD, LDN
• Corinna Marlene Castanon, LSW
• Kaitlain Cavender
• Center for Digestive Health

• Family Nurse Practitioner in Bourbonnais, IL
• Providers in Bourbonnais, 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 Feb 9, 2021; 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.