Individual provider Active NPI

Angela June Soder, M.D.

  • Psychiatry Physician
  • Lima, OH
National Provider Identifier
1033522925
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35133609 Issued in OH
Practice address
770 W High St Ste 300
Lima, OH 45801
Phone
(419) 996-5033
Fax
(419) 996-5266
NPI assigned
Jun 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 35133609 OH Primary

Addresses

Primary practice location

770 W High St Ste 300
Lima, OH 45801

Mailing address

770 W High St Ste 300
Lima, OH 45801-5914
Phone (419) 996-5033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180824000430 OH Practitioner - Psychiatry 6204138878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wright State University Boonshoft School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians

Practice addresses (Care Compare)

770 W High St
Suite 300
Lima, OH 45801-5914
Phone (419) 996-5033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35133609OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lima Specialty Care LLC Psychiatry CurrentSince Sep 1, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

770 W High St
Ste 450
Lima, OH 45801
Phone (419) 996-5069

770 W High St
Ste 300
Lima, OH 45801
Phone (419) 228-0570

770 W High St
Lima, OH 45801
Phone (419) 996-5240

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

Interoperability endpoints

  • Direct secure messaging: asoder425727@direct.bsmhealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1033522925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 W HIGH ST STE 300",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458015914",
            "telephone_number": "419-996-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 W HIGH ST STE 300",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "45801",
            "telephone_number": "419-996-5033",
            "fax_number": "419-996-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODER",
        "first_name": "ANGELA",
        "middle_name": "JUNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35133609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.