Active NPI
Angela Katherine Severado, FNP-BC AND PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 277.001329
- Practice address
- 1 Jefferson Barracks Rd
Saint Louis, MO 63125-4181 - Phone
- (314) 652-4100
- NPI assigned
- Aug 7, 2015
- Last updated
- May 6, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 277.001329 | IL | Primary |
Addresses
Primary practice location
1 Jefferson Barracks Rd
Saint Louis, MO 63125-4181
Mailing address
1660 Shadow Ridge CT Apt 10
Belleville, IL 62221-3905
Phone (217) 816-7928
Other practice location 1
1124 S 6th St
Springfield, IL 62703-2406
Phone (217) 523-3143
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 309.008660 | Medicaid | IL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
303 Fountains Pkwy
Suite 200
Fairview Heights, IL 62208-2074
Phone (618) 688-7020
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.44 of 100
- Quality
- 71.79
- Promoting interoperability
- 77
- Improvement activities
- 40
- Cost
- 75.71
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277.001329 | IL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HSHS Medical Group Inc | Current | Accepting new patients | |
| Divine Design Psychiatry and Wellness PLLC | Psychiatric/Mental Health | Current | Accepting new patients |
| Psychological Associates of Central Illinois LTD | Current | Accepting new patients | |
| TMS Neurohealth Illinois PLLC | Current | Accepting new patients | |
| HSHS Medical Group Inc | Current | Accepting new patients |
Locations
1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889
303 Fountains Pkwy
Ste 200
Fairview Hts, IL 62208
Phone (618) 688-7020
1124 S 6th St
Springfield, IL 62703
Phone (217) 523-3143
701 N Walnut St
Springfield, IL 62702
Phone (217) 528-1217
800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643
Interoperability endpoints
- greenbrooktmsmo.angelaseverado@158455.advancedmd-direct.com
Organizations & group practices 5
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.
-
- Psychiatry Physician
- Fairview Heights, IL
- NPI 1386292571
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1962644807
-
- Psychiatry Physician
- Springfield, IL
- NPI 1376698050
-
- Psychiatric/Mental Health Nurse Practitioner
- O'Fallon, IL
- NPI 1104779750
-
dba HSHS Medical Group Family Medicine - Dieterich
- Rural Health Clinic/Center
- Dieterich, IL
- NPI 1033841192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1952787376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 SHADOW RIDGE CT APT 10",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622213905",
"telephone_number": "217-816-7928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 JEFFERSON BARRACKS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631254181",
"telephone_number": "314-652-4100"
}
],
"practiceLocations": [
{
"address_1": "1124 S 6th St",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "IL",
"postal_code": "627032406",
"country_code": "US",
"telephone_number": "217-523-3143",
"fax_number": "217-523-1513",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEVERADO",
"first_name": "ANGELA",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "FNP-BC AND PMHNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-07",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "277.001329",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "309.008660",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.