Individual provider Active NPI

Angela Nicole Frageman, SLP

  • Speech-Language Pathologist
  • Quincy, IL
National Provider Identifier
1639464100
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
242.001609 Issued in IL
Practice address
1025 Maine St
Quincy, IL 62301-4038
Phone
(217) 222-6550
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 242.001609 IL Primary

Addresses

Primary practice location

1025 Maine St
Quincy, IL 62301-4038

Mailing address

3224 Acadia Way
Quincy, IL 62301-7401
Phone (217) 440-5600

Other names 1

  • Miss Angela N. McGinnis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120411000870 IL Practitioner - Qualified Speech Language Pathologist 6103087523 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
242.001609ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Mar 5, 2012 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Current Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Mar 5, 2012 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Past Accepting new patients

Locations

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

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": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1639464100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 ACADIA WAY",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623017401",
            "telephone_number": "217-440-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGEMAN",
        "first_name": "ANGELA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.001609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MCGINNIS",
            "middle_name": "N.",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.