Individual provider Active NPI

Angela C Nilles, LISW

  • Clinical Social Worker
  • Le Mars, IA
National Provider Identifier
1104303155
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
007749 Issued in IA
Practice address
180 10TH St SE Ste 201
Le Mars, IA 51031-2557
Phone
(712) 546-4624
Fax
(712) 546-9395
NPI assigned
Jul 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 007749 IA Primary

Addresses

Primary practice location

180 10TH St SE Ste 201
Le Mars, IA 51031-2557

Mailing address

PO Box 70
Le Mars, IA 51031-0070
Phone (712) 546-4624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20181026001146 IA Practitioner - Clinical Social Worker 7214280932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Plains Area Mental Health IncGroup PAC ID 5395649743, 24 clinicians

Practice addresses (Care Compare)

180 10TH St SE
Suite 201
Le Mars, IA 51031-2557
Phone (712) 546-4624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007749IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Plains Area Mental Health, Inc. CurrentSince Aug 25, 2018 Accepting new patients
Plains Area Mental Health, Inc. CurrentSince Aug 25, 2018 Accepting new patients

Locations

180 10th St SE
Ste 201
Le Mars, IA 51031
Phone 7125464624 ext. 2108

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": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1104303155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510310070",
            "telephone_number": "712-546-4624",
            "fax_number": "712-546-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 10TH ST SE STE 201",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510312557",
            "telephone_number": "712-546-4624",
            "fax_number": "712-546-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILLES",
        "first_name": "ANGELA",
        "middle_name": "C",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "007749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Mars, IA

Sources for this page

Verify at the official NPI Registry.