Cheryl A Carmack
Individual provider Active NPI Family Nurse Practitioner · Clinton, IL
NPI 1851640825 · NPPES record last updated Oct 25, 2013
Key facts
- NPI
- 1851640825
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209-009693 (IL)
- Practice address
- 1231 Kleemann Dr
Clinton, IL 61727-2633 - Phone
- (217) 935-5022
- Fax
- (217) 935-9592
- NPI assigned
- Sep 5, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
1505 Eastland Dr
Bloomington, IL 61701-3534
Phone (309) 662-5506
Hospital & facility affiliations
- St Joseph Medical Center
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 |
|---|---|---|---|---|
| I20121213000313 | IL | Practitioner - Nurse Practitioner | 2163674466 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-009693 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients |
Locations
1505 Eastland Dr
Ste 1100
Bloomington, IL 61701
Phone (309) 663-2100
1701 E College Ave
Bloomington, IL 61704
Phone (309) 664-3000
1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100
1231 Kleemann Dr
Clinton, IL 61727
Phone (217) 935-5022
801 Fox Run
Heyworth, IL 61745
Phone (309) 473-2069
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209-009693 | IL | Yes |
| Nurse Practitioner | 363L00000X | 209-009693 | IL |
Addresses
Primary practice location
1231 Kleemann Dr
Clinton, IL 61727-2633
Mailing address
1231 Kleemann Dr
Clinton, IL 61727-2633
Phone (217) 935-5022
Other names
- Cheryl A Nafziger
Other providers in Clinton, IL
- BL Behavioral Health PLLC
- David Michael Bowman
- Bruce C Butler
- Amy Marie Cabrera
- Theresa Agnes Calvert
- Cdonnan Enterprises LLC
- Randolph Christianson
- CHW Physical Therapy PC
- Robert Cipolla
- City of Clinton
All providers in Clinton, 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 Oct 25, 2013. 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.