Individual provider Active NPI

Angela Marie Todd, NP

  • Family Nurse Practitioner
  • Ottawa, IL
National Provider Identifier
1336565134
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.010887 Issued in IL
Practice address
1306 Gemini Cir Ste 1
Ottawa, IL 61350
Phone
(815) 433-9200
Fax
(815) 705-1716
NPI assigned
Mar 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.010887 IL Primary

Addresses

Primary practice location

1306 Gemini Cir Ste 1
Ottawa, IL 61350

Mailing address

725 School St Ste a
Morris, IL 60450-1207
Phone (815) 941-9124

Other practice location 1

603 W Mondamin St
Minooka, IL 60447-9057
Phone (815) 521-1010

Other practice location 2

603 W Mondamin St
Minooka, IL 60447-9057
Phone (815) 521-1010

Other identifiers 1

IdentifierTypeStateIssuer
209.010887OtherILIL LICENSE

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
I20140501001577 IL Practitioner - Nurse Practitioner 2860625662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

101 S Prairie Ave
Dwight, IL 60420-1350
Phone (815) 584-3291

1300 Starfire Dr a
Ottawa, IL 61350-1624
Phone (815) 324-9700

1306 Gemini Cir
Ottawa, IL 61350-1695

27240 W Saxony Dr
Channahon, IL 60410-1417

603 W Mondamin St
Minooka, IL 60447-9057
Phone (815) 581-1010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.010887ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital CurrentSince Mar 6, 2017 Accepting new patients
Morris Hospital Current Accepting new patients
Morris Hospital CurrentSince Mar 6, 2017 Accepting new patients
Morris Hospital Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

27240 W Saxony Dr
Ste 201
Channahon, IL 60410
Phone (815) 467-1518

603 W Mondamin St
Minooka, IL 60447
Phone (815) 521-1010

725 School St
Ste A
Morris, IL 60450

150 W High St
Morris, IL 60450
Phone (815) 942-2129

1306 Gemini Cir
Ste 1
Ottawa, IL 61350
Phone (815) 433-9200

Interoperability endpoints

  • Direct secure messaging: angela.todd@direct-address.org
  • Direct secure messaging: angela.todd.1@14307.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1336565134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SCHOOL ST STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501207",
            "telephone_number": "815-941-9124",
            "fax_number": "815-941-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 GEMINI CIR STE 1",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "61350",
            "telephone_number": "815-433-9200",
            "fax_number": "815-705-1716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 W Mondamin St",
            "address_purpose": "LOCATION",
            "city": "Minooka",
            "state": "IL",
            "postal_code": "604479057",
            "country_code": "US",
            "telephone_number": "815-521-1010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 W Mondamin St",
            "address_purpose": "LOCATION",
            "city": "Minooka",
            "state": "IL",
            "postal_code": "604479057",
            "country_code": "US",
            "telephone_number": "815-521-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODD",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.010887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "209.010887",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

Verify at the official NPI Registry.