Karagen Grace Fandel, APRN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Roanoke, IL
NPI 1992522924 · NPPES record last updated Sep 23, 2024
Key facts
- NPI
- 1992522924
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209030630 (IL)
- Practice address
- 401 N Main St
Roanoke, IL 61561-7585 - Phone
- (309) 923-2661
- NPI assigned
- Sep 23, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
200 E Pennsylvania Ave
Suite 101
Peoria, IL 61603-3084
Phone (309) 655-7888
3422 A Court St
Pekin, IL 61554-6235
Phone (309) 477-6000
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Saint Francis 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 |
|---|---|---|---|---|
| I20241023001367 | IL | Practitioner - Nurse Practitioner | 2365975810 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209030630 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint James Hospital | Current |
Accepting new patients | |
| Saint James Hospital | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Saint James Hospital | Current |
Accepting new patients |
Locations
124 SW Adams St
Fl 2
Peoria, IL 61602
Phone (309) 655-2850
200 E Pennsylvania Ave
Peoria, IL 61603
Phone (309) 624-4000
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209030630 | IL | Yes |
Addresses
Primary practice location
401 N Main St
Roanoke, IL 61561-7585
Mailing address
401 N Main St
Roanoke, IL 61561-7585
Phone (309) 923-2661
Other providers in Roanoke, IL
- Megan Elizabeth Cox
- Steven Lee Crawford
- Maddalena Davenport
- Paige Alexandria Dylewski
- Maddalena Fairchild
- Teresa Finegan
- Petra Flores
- Victoria Gorfin
- Renee Elizabeth Hemp
- Jennifer Brooke Jensen
All providers in Roanoke, 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 Sep 23, 2024. 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.