Individual provider Active NPI

Angela Marie Brumleve, APRN

  • Family Nurse Practitioner
  • Mattoon, IL
National Provider Identifier
1447600259
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.014092 Issued in IL
Practice address
1005 Health Center Dr
Mattoon, IL 61938-4629
Phone
(217) 258-2581
Fax
(217) 258-2186
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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 209.014092 IL Primary

Addresses

Primary practice location

1005 Health Center Dr
Mattoon, IL 61938-4629

Mailing address

PO Box 372
Mattoon, IL 61938-0372

Other practice location 1

900 W Temple Ave Ste 1500
Effingham, IL 62401-2121
Phone (217) 347-3303

Other practice location 2

503 N Maple St
Effingham, IL 62401-2006
Phone (217) 343-7417

Other practice location 3

601 W Washington St Ste 1
Newton, IL 62448
Phone (618) 783-0954

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
I20160803001246 IL Practitioner - Nurse Practitioner 6901190610 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.014092ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince Aug 12, 2024 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Aug 12, 2024 Accepting new patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third CurrentSince Jun 22, 2016 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients

Locations

900 W Temple Ave
Ste 1500
Effingham, IL 62401
Phone (217) 347-0458

900 W Temple Ave
Effingham, IL 62401
Phone (217) 347-5525

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

1005 Health Center Dr
Ste 104
Mattoon, IL 61938
Phone (217) 258-2178

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

601 W Washington St
Ste 1
Newton, IL 62448
Phone (217) 347-2707

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1447600259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384629",
            "telephone_number": "217-258-2581",
            "fax_number": "217-258-2186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 W Temple Ave Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624012121",
            "country_code": "US",
            "telephone_number": "217-347-3303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "503 N Maple St",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624012006",
            "country_code": "US",
            "telephone_number": "217-343-7417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 W Washington St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "IL",
            "postal_code": "62448",
            "country_code": "US",
            "telephone_number": "618-783-0954",
            "fax_number": "618-783-0958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUMLEVE",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.014092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.