Individual provider Active NPI

Angela Elizabeth Nauman-Musick, APRN,CNP

  • Nurse Practitioner
  • Swansea, IL
National Provider Identifier
1477530327
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209005423 Issued in IL
Practice address
4948 Benchmark Centre Dr
Swansea, IL 62226-2027
Phone
(618) 628-2588
Fax
(618) 628-1363
NPI assigned
Dec 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209005423 IL Primary

Addresses

Primary practice location

4948 Benchmark Centre Dr
Swansea, IL 62226-2027

Mailing address

4948 Benchmark Centre Dr
Swansea, IL 62226-2027
Phone (618) 628-2588

Other identifiers 1

IdentifierTypeStateIssuer
482829888MedicaidIL

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
I20051107000800 IL Practitioner - Nurse Practitioner 6709804859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musick Dermatology and Advanced Clinical Spa LLCGroup PAC ID 3577636604, 7 clinicians

Practice addresses (Care Compare)

4948 Benchmark Centre Dr
Swansea, IL 62226-2027
Phone (618) 628-2588

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209005423ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Musick Dermatology & Advanced Clinical Spa, LLC CurrentSince Jul 1, 2008 Accepting new patients
Distinctive Dermatologyltd Nurse Practitioner PastSince Sep 1, 1997 Accepting new patients

Locations

4932 Benchmark Centre Dr
Ste 3
Swansea, IL 62226
Phone (618) 628-2588

4948 Benchmark Centre Dr
Swansea, IL 62226
Phone (618) 628-2588

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/GRzkF6yCy_Pe-6F3SJzcXkCEiy_u6zZe/

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.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1477530327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4948 BENCHMARK CENTRE DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262027",
            "telephone_number": "618-628-2588",
            "fax_number": "618-628-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4948 BENCHMARK CENTRE DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262027",
            "telephone_number": "618-628-2588",
            "fax_number": "618-628-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUMAN-MUSICK",
        "first_name": "ANGELA",
        "middle_name": "ELIZABETH",
        "credential": "APRN,CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209005423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "482829888",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

Verify at the official NPI Registry.