Individual provider Active NPI

Peggy Derango, M.S.W., L.C.S.W.

  • Clinical Social Worker
  • Rockford, IL
National Provider Identifier
1801072046
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
6975 Redansa Dr
Rockford, IL 61108-1201
Phone
(814) 398-7000
NPI assigned
Jan 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

6975 Redansa Dr
Rockford, IL 61108-1201

Mailing address

6975 Redansa Dr
Rockford, IL 61108-1201
Phone (814) 398-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100119000643 IL Practitioner - Clinical Social Worker 5092857730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ann James Counseling LLCGroup PAC ID 8022239235, 2 clinicians

Practice addresses (Care Compare)

1639 N Alpine Rd
Suite 204
Rockford, IL 61107-1481
Phone (779) 423-0275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149009052ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ann James Counseling, LLC Clinical CurrentSince Nov 6, 2014 Accepting new patients

Locations

1639 N Alpine Rd
Ste 204
Rockford, IL 61107
Phone (779) 423-0275

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1801072046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6975 REDANSA DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081201",
            "telephone_number": "814-398-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6975 REDANSA DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081201",
            "telephone_number": "814-398-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERANGO",
        "first_name": "PEGGY",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.