Individual provider Active NPI

Angela M Gillmor

  • Family Nurse Practitioner
  • Sandusky, OH
National Provider Identifier
1811524333
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.025606 Issued in OH
Practice address
5420 Milan Rd
Sandusky, OH 44870-5846
Phone
(419) 557-5052
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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 APRN.CNP.025606 OH Primary

Addresses

Primary practice location

5420 Milan Rd
Sandusky, OH 44870-5846

Mailing address

5420 Milan Rd
Sandusky, OH 44870-5846
Phone (419) 557-5052

Other identifiers 1

IdentifierTypeStateIssuer
APRN.CNP.025522OtherOHLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200505002972 OH Practitioner - Nurse Practitioner 7315378445 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (419) 557-7400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
59.13
Promoting interoperability
99
Improvement activities
40
Cost
75.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.025606OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Professional Company, LLC CurrentSince Jun 1, 2025 Accepting new patients
North Coast Professional Company, LLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

5433 State Route 113
Bellevue, OH 44811
Phone (567) 256-3450

292 Benedict Ave
Norwalk, OH 44857
Phone (419) 663-3737

703 Tyler St
Ste 150
Sandusky, OH 44870
Phone (419) 625-8722

5420 Milan Rd
Sandusky, OH 44870
Phone (419) 557-5052

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

703 Tyler St
Ste 353
Sandusky, OH 44870

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

1100 Neal Zick Rd
Willard, OH 44890
Phone (419) 933-2811

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1811524333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 MILAN RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705846",
            "telephone_number": "419-557-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 MILAN RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705846",
            "telephone_number": "419-557-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLMOR",
        "first_name": "ANGELA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.025606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "APRN.CNP.025522",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.