1. Home
  2. Directory
  3. Illinois
  4. Moline
  5. Counselor
  6. NPI Profile

CARL D VINCENT
NPI 1922019991
Counselor - Professional in Moline, IL

Active since August 11, 2006PECOS EnrolledAccepts Medicare Assignment
2100 52ND AVE, MOLINE, IL 61265(309) 797-2900(309) 797-2147 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Carl D Vincent NPPES

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

CARL D VINCENT (NPI 1922019991) is an individual professional provider in Moline, Illinois and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1922019991
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameCARL D VINCENT
Location Address2100 52ND AVEMoline, IL 61265-6366
Mailing Address2100 52nd AveMoline, IL 61265-6366 · (309) 797-2900 · Fax (309) 797-2147
Phone(309) 797-2900
Fax(309) 797-2147
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateAugust 11, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1922019991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
2100 52ND AVE, Moline, IL 61265
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINL78997IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Wellmark Health Plan of Iowa, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carl D Vincent is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163667635
PECOS Enrollment IDI20240304001853
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 Carl Vincent reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southpark Psychology Ltd
Same address
Counseling
2100 52ND AVE
Moline, IL 61265
  • Reassigned Medicare billing, Illinois enrollment
  • 21 clinicians in this Medicare group
NPI 1558470419 (309) 797-2900

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

Other Providers at the Same Location NPPES 14

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

MS. ROSEMARY JORDAN LCSW
Social Worker (Clinical)
2100 52ND AVE
MOLINE, IL 61265
Rock Island County (309) 797-2900
JAMES D RAY LCPC
Counselor (Professional)
2100 52ND AVE
MOLINE, IL 61265
Rock Island County (309) 797-2900
JAMES J PUGLIANO LCSW
Social Worker (Clinical)
2100 52ND AVE
MOLINE, IL 61265
Rock Island County (309) 797-2900
GARY NORDICK PSY.D.
Psychologist
2100 52ND AVE
MOLINE, IL 61265
Rock Island County (309) 797-2900
FRANK WOOLLEY LCSW
Social Worker (Clinical)
2100 52ND AVE
MOLINE, IL 61265
Rock Island County (309) 797-2900
DR. GARY BRENT LUDWIG PH.D
Psychologist
2100 52ND AVE
MOLINE, IL 61265
Rock Island County (309) 797-2900
SOUTHPARK PSYCHOLOGY LTD
Psychologist (Counseling)
2100 52ND AVE
MOLINE, IL 61265
Rock Island County (309) 797-2900
BURT BOLT LCPC
Counselor (Professional)
2100 52ND AVE
MOLINE, IL 61265
Rock Island County (309) 797-2900

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 Carl Vincent's NPI number?

The NPI number for Carl Vincent is 1922019991. It was assigned to this individual provider in the NPPES registry on August 11, 2006.

Where is Carl Vincent located?

Carl Vincent practices at 2100 52nd Ave, Moline, IL 61265. The listed phone number is (309) 797-2900.

What is Carl Vincent's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Carl Vincent enrolled in Medicare?

Yes. Carl Vincent is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Carl Vincent's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carl Vincent reassigns Medicare benefits to Southpark Psychology Ltd (Moline, 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 Carl Vincent's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carl Vincent accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Wellmark Health Plan of Iowa, Inc. list Carl Vincent as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carl Vincent was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.