CREA ROSE
NPI 1366184053
Nurse Practitioner in Salem, IL

Q: What is Crea Rose's NPI number?

The NPI number for Crea Rose is 1366184053. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Q: What is Crea Rose's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Crea Rose was last updated on April 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 12, 2022PECOS Enrolled

95.01/100

CMS Quality Rating

207 E MAIN ST, SALEM, IL 62881(618) 740-2240(618) 740-2241 Get Directions Write a Review

NPPES record last updated: April 19, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Apr 19, 2026, Nov 23, 2022, Aug 2, 2022 and 1 more (4 updates tracked since 2022).

On this page

About Crea Rose NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CREA ROSE (NPI 1366184053) is an individual nurse practitioner in Salem, Illinois, licensed in Illinois (209.025104) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital -centralia, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1366184053

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameCREA ROSE

Location Address207 E MAIN STSalem, IL 62881-2926

Mailing Address207 E Main StSalem, IL 62881-2926 · (618) 740-2240 · Fax (618) 740-2241

Phone(618) 740-2240

Fax(618) 740-2241

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateApril 12, 2022

Last NPPES UpdateApril 19, 20264 updates tracked since enumeration

NPPES CertifiedApril 19, 2026

✔ NPI 1366184053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IL · 209.025104

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

207 E MAIN ST, Salem, IL 62881

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crea Rose is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911373261

PECOS Enrollment IDI20221012001039

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Crea Rose reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Revival Health And Wellness Clinic

Same address

Family Medicine

207 E MAIN ST
Salem, IL 62881

Reassigned Medicare billing, Illinois enrollment
2 clinicians in this Medicare group

NPI 1366241507 (706) 889-8349

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

138 services48 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

79 services38 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

66 services36 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

14 services14 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ssm Health St Mary's Hospital -Centralia

Acute Care Hospitals · Centralia, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140034

Location400 North Pleasant AvenueCentralia, IL 62801 · Marion County

Emergency services

Good Samaritan Regional Hlth Center

Acute Care Hospitals · Mount Vernon, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140046

Location1 Good Samaritan WayMount Vernon, IL 62864 · Jefferson County

Emergency services Birthing friendly

Sarah Bush Lincoln Health Center

Acute Care Hospitals · Mattoon, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140189

Location1000 Health Center Drive P O Box 372Mattoon, IL 61938 · Coles County

Emergency services Birthing friendly

Salem Township Hospital

Critical Access Hospitals · Salem, IL

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number141345

Location1201 Ricker DriveSalem, IL 62881 · Marion County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62881 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.01/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.02

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINA MARIE WEIBLEY FNP-C, FPA

Nurse Practitioner (Family)

207 E MAIN ST
SALEM, IL 62881

Marion County (618) 740-2240

REVIVAL HEALTH AND WELLNESS CLINIC

Family Medicine

207 E MAIN ST
SALEM, IL 62881

Marion County (706) 889-8349

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crea Rose's NPI number?

The NPI number for Crea Rose is 1366184053. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Where is Crea Rose located?

Crea Rose practices at 207 E Main St, Salem, IL 62881. The listed phone number is (618) 740-2240.

What is Crea Rose's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Crea Rose enrolled in Medicare?

Yes. Crea Rose is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Crea Rose's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Crea Rose reassigns Medicare benefits to Revival Health And Wellness Clinic (Salem, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Crea Rose's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Crea Rose affiliated with any hospitals?

According to CMS data, Crea Rose is affiliated with Ssm Health St Mary's Hospital -Centralia, Good Samaritan Regional Hlth Center, Sarah Bush Lincoln Health Center and Salem Township Hospital.

When was this NPI record last updated?

The NPPES record for Crea Rose was last updated on April 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.