Individual provider Active NPI

Angie D Yocom, APN BC FNP

  • Nurse Practitioner
  • Effingham, IL
National Provider Identifier
1841398468
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-005974 Issued in IL
Practice address
414 W Virginia Ave
Effingham, IL 62401-2258
Phone
(217) 342-9738
Fax
(217) 342-9806
NPI assigned
Sep 20, 2006
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-005974 IL Primary

Addresses

Primary practice location

414 W Virginia Ave
Effingham, IL 62401-2258

Mailing address

414 W Virginia Ave
Effingham, IL 62401-2258
Phone (217) 342-9738

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ayocom165562@ewd.direct.hshs.org Direct

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070731000523 IL Practitioner - Nurse Practitioner 7810098100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1836 S Macarthur Blvd
Springfield, IL 62704-4030
Phone (217) 789-1403

1900 E Lake Shore Dr
Suite 330
Decatur, IL 62521-3848
Phone (217) 423-2889

414 W Virginia Ave
Effingham, IL 62401-2258
Phone (217) 342-9738

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-005974ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Prairie, Inc CurrentSince Sep 1, 2022 Accepting new patients
HSHS Prairie, Inc CurrentSince Sep 1, 2022 Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

414 W Virginia Ave
Effingham, IL 62401
Phone 2173429738 ext. 103

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1841398468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W VIRGINIA AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012258",
            "telephone_number": "217-342-9738",
            "fax_number": "217-342-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W VIRGINIA AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012258",
            "telephone_number": "217-342-9738",
            "fax_number": "217-342-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOCOM",
        "first_name": "ANGIE",
        "middle_name": "D",
        "credential": "APN BC FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-005974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ayocom165562@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "414 W Virginia Ave",
            "city": "Effingham",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624012258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

Verify at the official NPI Registry.