Individual provider Active NPI

Angela Michelle Roegner, LCSW

  • Clinical Social Worker
  • Kokomo, IN
National Provider Identifier
1528193919
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004635A Issued in IN
Practice address
702 W Alto Road
Kokomo, IN 46902
Phone
(765) 453-7422
Fax
(765) 453-3773
NPI assigned
Feb 23, 2007
Last updated
Apr 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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 34004635A IN Primary

Addresses

Primary practice location

702 W Alto Road
Kokomo, IN 46902

Mailing address

PO Box 6459
Kokomo, IN 46904-6459
Phone (765) 453-7422

Other identifiers 1

IdentifierTypeStateIssuer
100154150AMedicaidIN

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
I20050712000155 IN Practitioner - Clinical Social Worker 4385670397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oasis Counseling Center LLCGroup PAC ID 4385873124, 2 clinicians

Practice addresses (Care Compare)

1531 Rockford CT
Kokomo, IN 46902-3207
Phone (765) 453-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34004635AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Oasis Counseling Center LLC Clinical CurrentSince Oct 7, 2013 Accepting new patients
Mending Minds, LLC PastSince Mar 1, 2022 Accepting new patients

Locations

1531 Rockford Ct
Kokomo, IN 46902
Phone (765) 453-4500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24167/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1528193919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6459",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469046459",
            "telephone_number": "765-453-7422",
            "fax_number": "765-453-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W ALTO ROAD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "46902",
            "telephone_number": "765-453-7422",
            "fax_number": "765-453-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEGNER",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004635A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100154150A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.