Individual provider Active NPI

Ann Elizabeth Pitcavage, MHP

  • Case Manager/Care Coordinator
  • Waterloo, IL
National Provider Identifier
1356089494
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
988 N Illlinois Route 3
Waterloo, IL 62299
Phone
(618) 939-4444
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

988 N Illlinois Route 3
Waterloo, IL 62299

Mailing address

PO Box 146
Waterloo, IL 62298-0146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1356089494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622980146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 N ILLLINOIS ROUTE 3",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "62299",
            "telephone_number": "618-939-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITCAVAGE",
        "first_name": "ANN",
        "middle_name": "ELIZABETH",
        "credential": "MHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.