CARRIE LYN NOONAN (NP-C) – Registered Nurse, NPI 1114339470
Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for CARRIE LYN NOONAN (NP-C)
11560 OLIVE BLVD
CREVE COEUR, MO 631417111
Phone: (618) 520-4512
Type: Mailing
2708 CHEYENNE WELLS DR
BELLEVILLE, IL 622213546
Phone: (618) 520-4512
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $61.
Total Amount is formed as General ($61) + Research ($0) + Ownership ($0) = $61.
Last reported payment date: 2024-09-25 • Largest payer in this snapshot: PFIZER INC. ($61).
Total Amount
$61
General + Research + Ownership
Payments
1
Total payment records
General Amount
$61
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $61 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140721000480 | I | Nurse Practitioner | MO | TBD |
| I20170313001058 | I | Nurse Practitioner | IL | TBD |
| I20251025000217 | I | Nurse Practitioner | NM | TBD |
| I20251121001702 | I | Nurse Practitioner | WA | TBD |
| I20251121002421 | I | Nurse Practitioner | UT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63141)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | MO | 90670 | Pneumococcal vaccine for injection into muscle | 13 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WA | |
| - | NM | |
| Nurse Practitioner | MO | |
| - | NM | |
| - | NM | |
| Nurse Practitioner | NM | |
| Physician Assistant | MN |
Reviews
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