NPIMap

Individual provider Active NPI

Angela Thill, FNP-C

  • Family Nurse Practitioner
  • Gravois Mills, MO
National Provider Identifier
1790452225
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021029996 Issued in MO
Practice address
156 Missouri Blvd
Gravois Mills, MO 65037-5394
Phone
(573) 374-5263
Fax
(573) 374-4933
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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 2021029996 MO Primary

Addresses

Primary practice location

156 Missouri Blvd
Gravois Mills, MO 65037-5394

Mailing address

246 Whispering Cove Drive
Camdenton, MO 65020
Phone (515) 708-5204

Other names 1

  • Angela Spencer Former name

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
I20210830000306 MO Practitioner - Nurse Practitioner 0840695888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Regional Health SystemGroup PAC ID 9133026776, 132 clinicians

Practice addresses (Care Compare)

226 E US Hwy 54
Camdenton, MO 65020-6819
Phone (573) 873-2521

54 Hospital Dr
Osage Beach, MO 65065-3050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.19 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
75.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021029996MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Regional Health System CurrentSince Oct 1, 2021 Accepting new patients
Lake Regional Health System CurrentSince Oct 1, 2021 Accepting new patients
Lake Regional Health System Current Accepting new patients

Locations

226 E US Highway 54
Camdenton, MO 65020
Phone (573) 346-3700

156 Missouri Blvd
Ste B
Gravois Mills, MO 65037
Phone (573) 374-5263

156 Missouri Blvd
Gravois Mills, MO 65037
Phone (573) 374-5263

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

1057 Medical Park Dr
Osage Beach, MO 65065
Phone (573) 302-3100

Interoperability endpoints

  • Direct secure messaging: angelathill@mhccaremail.com

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1790452225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 WHISPERING COVE DRIVE",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "65020",
            "telephone_number": "515-708-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 MISSOURI BLVD",
            "city": "GRAVOIS MILLS",
            "state": "MO",
            "postal_code": "650375394",
            "telephone_number": "573-374-5263",
            "fax_number": "573-374-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THILL",
        "first_name": "ANGELA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021029996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "SPENCER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gravois Mills, MO

Sources for this page

Verify at the official NPI Registry.