ANGELA DAWN HERNDON (APN) – Nurse Practitioner, NPI 1265548986

ANGELA DAWN HERNDON (APN) is a healthcare provider. based in Mascoutah, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APN. They hold a License No. 041328145 (IL). The NPI Number for ANGELA DAWN HERNDON (APN) is 1265548986

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
ANGELA DAWN HERNDON (APN)
NPI
1265548986
Phone
(618) 566-8810
Address
739 N JEFFERSON ST
Enumeration Date
23 August 2006
Last Update Date
20 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6185264700
Graduation Year
2005 (21 years ago)
PAC ID
5496775678
Group Practice PAC ID
3173055506
Professional Enrollment ID
I20051202000177
Address ID
IL622301528BR397XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

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Provider Addresses for ANGELA DAWN HERNDON (APN)

  • Rural Family Medicine Associates, 739, North Jefferson Street, Mascoutah, Saint Clair County, Illinois, 62258, United States

    SUITE 200

    MASCOUTAH, IL 622581447

    Phone: (618) 566-8810

    Fax: (618) 566-7121

    Type: Mailing

  • 397 NORTH PLUM STREET

    BREESE, IL 622309998

    Phone: (618) 526-4700

    Fax: (618) 566-7121

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 67 Open Payments records for all available years, with a total value of $1,097.

Total Amount is formed as General ($1,097) + Research ($0) + Ownership ($0) = $1,097.

Last reported payment date: 2024-09-12 • Largest payer in this snapshot: ABBVIE INC. ($375).

Total Amount

$1,097

General + Research + Ownership

Payments

67

Total payment records

General Amount

$1,097

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-12

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-12-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20051202000177INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62258)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173055506View full group profile
NameSpecialtyState
C H I R O P R A C T I CIL
C H I R O P R A C T I CIL

Reviews

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Frequently asked questions

Where can patients find ANGELA DAWN HERNDON (APN)'s NPI?
You can confirm ANGELA DAWN HERNDON (APN) with NPI 1265548986; it appears in the national provider directory.
Is ANGELA DAWN HERNDON (APN)'s NPI currently valid?
The extract we use shows ANGELA DAWN HERNDON (APN) as active.
What field does ANGELA DAWN HERNDON (APN) work in?
You can think of ANGELA DAWN HERNDON (APN) as practicing within Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for ANGELA DAWN HERNDON (APN)?
The page summarizes Mascoutah, Illinois for ANGELA DAWN HERNDON (APN); expand the address list for detail.
What if Mascoutah, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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