Active NPI
Angelina Dawkins
- Social Worker
- Champaign, IL
National Provider Identifier
1316445117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 122 W Hill St
Champaign, IL 61820-3519 - Phone
- (217) 356-7576
- Fax
- (217) 356-6571
- NPI assigned
- Jan 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
122 W Hill St
Champaign, IL 61820-3519
Mailing address
1021 N Mulford Rd
Rockford, IL 61107-3877
Phone (815) 387-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 21, 2021 through Jan 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Csog LLC | Past | Accepting new patients | |
| Two Roads Wellness Clinic, LLC | Past | Accepting new patients |
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.
-
dba Two Roads Wellness Clinic
- Primary Care Nurse Practitioner
- Danville, IL
- NPI 1417329426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1316445117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 N MULFORD RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611073877",
"telephone_number": "815-387-5600",
"fax_number": "815-316-4726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 W HILL ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203519",
"telephone_number": "217-356-7576",
"fax_number": "217-356-6571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWKINS",
"first_name": "ANGELINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-26",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.