Carolyn Hagerty, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.024736 Issued in IL

Practice address

1111 Trinity LN Ste 111
Bloomington, IL 61704-8112

Phone

(309) 663-6461

NPI assigned

Feb 7, 2022

Last updated

Oct 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Applebaum Physiatry PLLCGroup PAC ID 8729453436, 141 clinicians

Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Bromenn Medical Center Hospital, Normal, IL, CCN 140127
• Saint James Hospital Hospital, Pontiac, IL, CCN 140161

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chagertyaprn415137@carlehiedirect.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.

• Applebaum Physiatry PLLC

  • Physical Medicine & Rehabilitation Physician
  • Oak Brook, IL
  • NPI 1700598059

  Family

  Medicare reassignment Care Compare group NPD
• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment Care Compare group NPD
• Allied Health Group, LTD

  dba Central IL Spine

  • Chiropractor
  • Normal, IL
  • NPI 1467574731
  Medicare reassignment NPD
• Carle Bromenn Medical Center

  dba Bromenn Family Health Clinic

  • Clinic/Center
  • Normal, IL
  • NPI 1104442615
  Medicare reassignment NPD
• Carle Bromenn Medical Center

  dba Advocate BroMenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  NPD

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

• Carle Bromenn Medical Center

  dba Advocate BroMenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  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": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1942954169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 TRINITY LN STE 111",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048112",
            "telephone_number": "309-663-6461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1603 Visa Dr",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617612131",
            "country_code": "US",
            "telephone_number": "309-268-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "908 N Elm St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605213625",
            "country_code": "US",
            "telephone_number": "630-794-9999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGERTY",
        "first_name": "CAROLYN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "2029.024736",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.024736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caeli M Haab
• Olivia Haas
• Michelle R Haase, LCSW
• Hadassah Carlson Counseling PLLC
• H. Ross Hadden, D.P.M.
• Stefani J Hagglund, PA-C
• Deanna M Hahn, D.O.
• Jennifer Marie Hair, PTA
• Joyce Haley
• Genesis A Hall, LCSW

• Family Nurse Practitioner in Bloomington, IL
• Providers in Bloomington, 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 Oct 3, 2024; 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.