Angela R Menz, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

147218 Issued in MO

Practice address

611 W Main St
Fredericktown, MO 63645

Phone

(573) 783-4111

Fax

(573) 783-1065

NPI assigned

Aug 18, 2006

Last updated

Oct 19, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians of Memphis LLCGroup PAC ID 5395643209, 92 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277

  MO

  Medicare reassignment Care Compare group NPD
• Madison Medical Center Stockhoff Memorial Nursing Home

  • Critical Access Hospital
  • Fredericktown, MO
  • NPI 1720163025
  Medicare reassignment NPD
• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661
  Medicare reassignment NPD
• Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
  • NPI 1508967860
  Medicare reassignment NPD
• Sikeston Emergency Group LLC

  • Emergency Medicine Physician
  • Sikeston, MO
  • NPI 1427575299
  Medicare reassignment NPD
• Southeastern Emergency Services of Memphis, P.C.

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1164454450

  MO

  Medicare reassignment NPD
• Madison Medical Center Stockhoff Memorial Nursing Home

  dba Madison Medical Center

  • Skilled Nursing Facility
  • Fredericktown, MO
  • NPI 1215003041
  NPD
• Mercy Hospital Jefferson

  dba Mercy Home Health

  • Home Health Agency
  • Festus, MO
  • NPI 1396748588
  NPD
• Missouri Delta Medical Center

  dba Delta Regional Pharmacy

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1114309168
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1619081593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W MAIN ST",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636451111",
            "telephone_number": "573-783-4111",
            "fax_number": "573-783-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W MAIN ST",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "63645",
            "telephone_number": "573-783-4111",
            "fax_number": "573-783-1065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sikeston",
            "state": "MO",
            "postal_code": "638015044",
            "country_code": "US",
            "telephone_number": "573-472-6001",
            "fax_number": "573-472-6006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1403 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "MO",
            "postal_code": "63834",
            "country_code": "US",
            "telephone_number": "573-683-2327",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1403 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "MO",
            "postal_code": "63834",
            "country_code": "US",
            "telephone_number": "573-683-2327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENZ",
        "first_name": "ANGELA",
        "middle_name": "R",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "147218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Memorial Hospital Stockhoff Memorial Nursing Home (Madison Medical Center)
• Madison Memorial Hospital Stockhoff Memorial Nursing Home (Madison Medical Center)
• Madison Memorial Hospital Stockhoff Memorial Nursing Home (Madison Medical Center)
• Emily Brooke McCulley, PLPC
• Christopher M McDowell, LMT
• Abigail Louisa Meza, RD, LD
• Midwest Health Group Convenient Care, LLC (Midwest Convenient Care)
• Craig J. Millham, P.T.
• Modern Mental Health
• Sarah Pauline Mueller, PMHNP-BC

• Family Nurse Practitioner in Fredericktown, MO
• Providers in Fredericktown, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.