Individual provider Active NPI

Terra Lynn Ogle, LCSW

  • Clinical Social Worker
  • Mattoon, IL
National Provider Identifier
1336322734
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.014957 Issued in IL
Practice address
750 Broadway Ave E
Mattoon, IL 61938-4610
Phone
(217) 238-5700
Fax
(217) 238-5767
NPI assigned
Dec 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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 149.014957 IL Primary

Addresses

Primary practice location

750 Broadway Ave E
Mattoon, IL 61938-4610

Mailing address

750 Broadway Ave E
Mattoon, IL 61938-4610
Phone (217) 238-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20190205000123 IN Practitioner - Clinical Social Worker 8729394184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Union Hospital IncGroup PAC ID 8426943614, 90 clinicians

Practice addresses (Care Compare)

1606 N 7TH St
Union Hospital Inc Med GRP
Terre Haute, IN 47804-2706
Phone (812) 238-7000

Hospital & facility affiliations

  • Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.014957ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital, Inc. CurrentSince Dec 30, 2018 Accepting new patients
Union Hospital, Inc. CurrentSince Dec 30, 2018 Accepting new patients

Locations

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

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.

Hospital & facility affiliations 2

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": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1336322734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BROADWAY AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384610",
            "telephone_number": "217-238-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BROADWAY AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384610",
            "telephone_number": "217-238-5700",
            "fax_number": "217-238-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLE",
        "first_name": "TERRA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.