Carl D Vincent

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2100 52ND Ave
Moline, IL 61265-6366

Phone

(309) 797-2900

Fax

(309) 797-2147

NPI assigned

Aug 11, 2006

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

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

Specialty

Mental Health Counselor

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southpark Psychology LTDGroup PAC ID 8527203090, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Southpark Psychology LTD

  • Counseling Psychologist
  • Moline, IL
  • NPI 1558470419

  Professional

  Medicare reassignment Care Compare group NPD Authorized official
• Advanced Cardiovascular Consultants,SC

  • Specialist
  • Moline, IL
  • NPI 1588718910
  NPD

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922019991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 52ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656366",
            "telephone_number": "309-797-2900",
            "fax_number": "309-797-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 52ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656366",
            "telephone_number": "309-797-2900",
            "fax_number": "309-797-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "CARL",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole Versluis, PHARMD
• Joann Vesole, RD, LDN, CDE
• Cristina Vieyra
• Willem Gerhardus Viljoen, RPH
• Martha Villafana, MA
• Pamela S. Vipond, APRN
• Virdi Dental
• Manisha Virdi, DDS
• Andrea Viren
• Julie Lynn Voelker, M.D.

• Professional Counselor in Moline, IL
• Providers in Moline, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.