Angie J Whitesell, M.D.
Individual provider Active NPI Family Medicine Physician · Lockwood, MO
NPI 1689679391 · NPPES record last updated Jan 9, 2009
Key facts
- NPI
- 1689679391
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2003014018 (MO)
- Practice address
- 1307 Main Street
Lockwood, MO 65682 - Phone
- (417) 232-4560
- Fax
- (417) 232-4611
- NPI assigned
- Jun 17, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 25
Owned or controlled facilities with NPI records 15
Medicare Care Compare profile
- 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 Communities
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
- Integrity Home Care + Hospice
- Hospice Compassus-Southwest Missouri
- Gentiva
- Integrity Home Care + Hospice
- Mercy Hospital Springfield
- Mercy Hospital Carthage
- Mercy Hospital Aurora
- Citizens Memorial Hospital
- Mercy Hospital Joplin
- Good Shepherd Community Care and Rehabilitation
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 11 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 15
| Facility | Type | Role | Since |
|---|---|---|---|
| Mercy Clinic Family Medicine - Steelville |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic - St. James |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic - St. Robert |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic Pediatrics-Rolla |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic Family Medicine - Mountain Grove |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic Family Medicine-Branson West |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic Family Medicine- Cassville |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic Family Medicine-El Dorado Springs |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic Pediatrics-Lebanon |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic Family Medicine-Buffalo |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic-Lebanon-Family Medicine |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic Family Medicine-Richland |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic - Birch Tree |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic -Salem |
Rural health clinic | Corporate Director | Jul 1, 2019 |
| Mercy Clinic Family Medicine-Mountain View |
Rural health clinic | Corporate Director | Jul 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050718000358 | MO | Practitioner - Family Practice |
0143256537 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Family Medicine | Current |
Accepting new patients |
| Mercy Clinic Springfield Communities | Family Medicine | Current |
Accepting new patients |
| Mercy Clinic Springfield Communities | Family Medicine | Current |
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
3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056
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
Fl 5
Springfield, MO 65807
620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215
Interoperability endpoints
- awhitesell14263@directb.mercy.net
- awhitesell12857@directc.mercy.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2003014018 | MO | Yes |
| 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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431560263 | Other | TRICARE WEST | |
| 207274408 | Medicaid | MO |
Other providers in Lockwood, MO
All providers in Lockwood, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.