Individual provider Active NPI

Monica L Nagele, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Carbondale, IL
National Provider Identifier
1093387854
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209023555 Issued in IL
Practice address
1175 Cedar CT
Carbondale, IL 62901-5333
Phone
(618) 490-1045
NPI assigned
Jul 12, 2021
Last updated
Sep 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2021025602 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209023555 IL Primary

Addresses

Primary practice location

1175 Cedar CT
Carbondale, IL 62901-5333

Mailing address

1908 Brown PL
Murphysboro, IL 62966-2423

Other identifiers 1

IdentifierTypeStateIssuer
420100878MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210914001559 MO Practitioner - Nurse Practitioner 5193121374 Reassigns benefits to 1 organization
I20230403000748 IL Practitioner - Nurse Practitioner 5193121374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Counseling CenterGroup PAC ID 9436142460, 22 clinicians

Practice addresses (Care Compare)

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone 57333411002780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2021025602MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling Center CurrentSince Sep 7, 2021 Accepting new patients

Locations

402 S Silver Springs Rd
Cpe Girardeau, MO 63703
Phone (573) 334-1100

309 Garrett St
Fredericktown, MO 63645
Phone (573) 783-4104

820 Park Dr
Ste Genevieve, MO 63670
Phone (573) 883-7407

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1093387854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 BROWN PL",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629662423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 CEDAR CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015333",
            "telephone_number": "618-490-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGELE",
        "first_name": "MONICA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2021025602",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209023555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420100878",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.