Deandra Rangel

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

612 N 11TH St
Quincy, IL 62301-2662

Phone

(217) 224-9484

NPI assigned

Sep 29, 2014

Last updated

Oct 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Deandra Bockhold Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Board of Trustees of Southern Illinois UniversityGroup PAC ID 4486667888, 139 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• IL PPO Downstate
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IL HMO C-SNP
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

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.

• Board of Trustees of Southern Illinois University

  dba Siu Center for Family Medicine

  • Primary Care Clinic/Center
  • Springfield, IL
  • NPI 1396097960
  Medicare reassignment Care Compare group NPD
• Board of Trustees of Southern Illinois University

  dba SIU Center for Family Medicine - Care-A-Van

  • Federally Qualified Health Center (FQHC)
  • Carbondale, IL
  • NPI 1568210425
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1003219593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S 24TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014446",
            "telephone_number": "217-592-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N 11TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012662",
            "telephone_number": "217-224-9484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 S 24th St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623014446",
            "country_code": "US",
            "telephone_number": "217-592-0338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANGEL",
        "first_name": "DEANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANDRA",
            "last_name": "BOCKHOLD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffaney K. Rains-Eaton, LCPC
• Jackie Lynn Raleigh, BA, MSW, QMHP
• Ezhiludai Nambi Ramamoorthy, MD, MBBS
• Madison Ramey, MA, LPC
• Douglas C Raney, D.C.
• Kristen Renee Rasche
• Makenna Rathbun, APRN-FNP
• Molly Katherine Ravenscraft-Evans, CRNA
• Margaret E Reagan, P.T.
• Mary Rebman, RDH, PHDH

• Social Worker in Quincy, IL
• Providers in Quincy, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.