ANGELA GADDIS (APN) – Nurse Practitioner, NPI 1649773946

ANGELA GADDIS (APN) is a healthcare provider. based in Lawrenceville, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APN. They hold a License No. 209.017328 (IL). The NPI Number for ANGELA GADDIS (APN) is 1649773946

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
ANGELA GADDIS (APN)
NPI
1649773946
Phone
(618) 943-2609
Address
11020 STATE ROUTE 250
Enumeration Date
13 March 2018
Last Update Date
25 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2174664226
Graduation Year
2017 (9 years ago)
PAC ID
7113272956
Group Practice PAC ID
7315933827
Professional Enrollment ID
I20220426002195
Address ID
IL619446619PA15317150X400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

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Provider Addresses for ANGELA GADDIS (APN)

  • West Haven Road, Lawrenceville, Lawrence County, Illinois, 62439, United States

    LAWRENCEVILLE, IL 624393379

    Phone: (618) 943-2609

    Type: Location

  • 1418 COLLEGE DR

    MOUNT CARMEL, IL 628632638

    Phone: (317) 613-1006

    Type: Location

  • 9751 N 1710TH ST

    PALESTINE, IL 624512632

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2022-04-26

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
I20220426002195INurse 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 62439)

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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: 7315933827View full group profile
NameSpecialtyState
Nurse PractitionerIL
-IL
Cardiovascular Disease (Cardiology)IL
Nurse PractitionerIL
-IL
A N E S T H E S I O L O G YIN
Nurse PractitionerIL
P S Y C H I A T R YIN
Family PracticeIL
Emergency MedicineIL

Reviews

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Frequently asked questions

Where can patients find ANGELA GADDIS (APN)'s NPI?
You can confirm ANGELA GADDIS (APN) with NPI 1649773946; it appears in the national provider directory.
Is ANGELA GADDIS (APN) active in the national directory?
ANGELA GADDIS (APN)'s public NPI profile is in an active state.
Can you summarize ANGELA GADDIS (APN)'s specialty in plain language?
Clinically, the directory lists ANGELA GADDIS (APN) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for ANGELA GADDIS (APN)?
The page summarizes Lawrenceville, Illinois for ANGELA GADDIS (APN); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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