Individual provider Active NPI

Angela M Stanley, NP

  • Family Medicine Physician
  • Rockford, IL
National Provider Identifier
1235807900
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
209.023268 Issued in IL
Practice address
612 Roxbury Rd
Rockford, IL 61107-5089
Phone
(815) 227-8331
Fax
(855) 243-0207
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 209.023268 IL Primary

Addresses

Primary practice location

612 Roxbury Rd
Rockford, IL 61107-5089

Mailing address

607 S Shabbona Rd
Shabbona, IL 60550-9785
Phone (815) 739-7309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210928000144 IL Practitioner - Nurse Practitioner 4486051828 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
Rna of Rockford, PLLCGroup PAC ID 3870662398, 18 clinicians

Practice addresses (Care Compare)

612 Roxbury Rd
Rockford, IL 61107-5089
Phone (815) 227-8300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.99 of 100Reported as group
Quality
83.04
Promoting interoperability
100
Improvement activities
40
Cost
77.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.023268ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rna of Rockford, PLLC CurrentSince Jun 18, 2021 Accepting new patients

Locations

900 N 2nd St
Rochelle, IL 61068
Phone (815) 562-2181

612 Roxbury Rd
Rockford, IL 61107
Phone (815) 227-8300

Organizations & group practices 1

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1235807900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S SHABBONA RD",
            "city": "SHABBONA",
            "state": "IL",
            "postal_code": "605509785",
            "telephone_number": "815-739-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075089",
            "telephone_number": "815-227-8331",
            "fax_number": "855-243-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "209.023268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.