Individual provider Active NPI

Angela R Clevenger, CFNP

  • Family Nurse Practitioner
  • Quincy, IL
National Provider Identifier
1700067725
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Practice address
612 N 11TH St
Ste B
Quincy, IL 62301-2662
Phone
(217) 224-9484
Fax
(217) 224-7950
NPI assigned
Nov 19, 2007
Last updated
Dec 7, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X IL Primary

Addresses

Primary practice location

612 N 11TH St
Ste B
Quincy, IL 62301-2662

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-7578

Other names 1

  • Angela R Hindbaugh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
209-006828ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Organizations & group practices 1

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": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1700067725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-7578",
            "fax_number": "217-545-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N 11TH ST",
            "address_2": "STE B",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012662",
            "telephone_number": "217-224-9484",
            "fax_number": "217-224-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVENGER",
        "first_name": "ANGELA",
        "middle_name": "R",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "HINDBAUGH",
            "middle_name": "R",
            "credential": "CFNP",
            "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 Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.