NPIMap

Individual provider Active NPI

Angie J Whitesell, M.D.

  • Family Medicine Physician
  • Lockwood, MO
National Provider Identifier
1689679391
Registry record updated Jan 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2003014018 Issued in MO
Practice address
1307 Main Street
Lockwood, MO 65682
Phone
(417) 232-4560
Fax
(417) 232-4611
NPI assigned
Jun 17, 2005
Last updated
Jan 9, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2003014018 MO Primary
Obstetrics & Gynecology Physician 207V00000X 2003014018 MO

Addresses

Primary practice location

1307 Main Street
Lockwood, MO 65682

Mailing address

1307 N Main St
Nevada, MO 64772-1129
Phone (417) 232-4560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050718000358 MO Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 0143256537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1307 S Main St
MC Family Medicine Lockwood
Lockwood, MO 65682-8327
Phone (417) 232-4560

1319 S Landrum St
Suite a
Mount Vernon, MO 65712-1976
Phone (417) 888-6708

1605 Martin Springs Dr
Rolla, MO 65401-2980

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions11
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Apr 9, 2018 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Dec 1, 2008 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Dec 1, 2008 Accepting new patients
Good Shepherd Nursing Home Past Accepting new patients

Locations

1307 S Main St
Lockwood, MO 65682
Phone (417) 232-4560

1319 S Landrum St
Ste A
Mount Vernon, MO 65712
Phone (417) 466-2001

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1423 N Jefferson Ave
Springfield, MO 65802
Phone (417) 269-6583

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

3801 S National Ave
Fl 5
Springfield, MO 65807

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 581-8170

Interoperability endpoints

  • Direct secure messaging: awhitesell12857@directc.mercy.net
  • Direct secure messaging: awhitesell14263@directb.mercy.net

Ownership & related parties

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy Clinic Family Medicine - SteelvilleSteelville, MO, CCN 263850 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic - St. JamesSaint James, MO, CCN 263943 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic - St. RobertSaint Robert, MO, CCN 263813 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic Pediatrics-RollaRolla, MO, CCN 268935 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic Family Medicine - Mountain GroveMountain Grove, MO, CCN 263840 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic Family Medicine-Branson WestBranson West, MO, CCN 263918 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic Family Medicine- CassvilleCassville, MO, CCN 263909 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic Family Medicine-El Dorado SpringsEl Dorado Springs, MO, CCN 263900 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic Pediatrics-LebanonLebanon, MO, CCN 263831 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic Family Medicine-BuffaloBuffalo, MO, CCN 263921 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic-Lebanon-Family MedicineLebanon, MO, CCN 263814 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic Family Medicine-RichlandRichland, MO, CCN 263934 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic - Birch TreeBirch Tree, MO, CCN 263806 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic -SalemSalem, MO, CCN 263870 Rural health clinic Corporate Director Jul 1, 2019
Mercy Clinic Family Medicine-Mountain ViewMountain View, MO, CCN 263819 Rural health clinic Corporate Director Jul 1, 2019

Owned or controlled facilities with NPI records 15

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 15

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

Hospital & facility affiliations 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1689679391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 N MAIN ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647721129",
            "telephone_number": "417-232-4560",
            "fax_number": "417-232-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 MAIN STREET",
            "city": "LOCKWOOD",
            "state": "MO",
            "postal_code": "65682",
            "telephone_number": "417-232-4560",
            "fax_number": "417-232-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESELL",
        "first_name": "ANGIE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2003014018",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2003014018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockwood, MO

Sources for this page

Verify at the official NPI Registry.