Individual provider Active NPI

Julian Alexander Angeles

  • Prosthetist
  • Marietta, GA
National Provider Identifier
1003556242
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
206 Issued in GA
Practice address
61 Whitcher St NE Ste 2120
Marietta, GA 30060-1180
Phone
(770) 423-0595
Fax
(678) 391-5055
NPI assigned
Mar 29, 2022
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X 206 GA Primary

Addresses

Primary practice location

61 Whitcher St NE Ste 2120
Marietta, GA 30060-1180

Mailing address

61 Whitcher St NE Ste 2120
Marietta, GA 30060-1180
Phone (770) 423-0595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
206GAMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1003556242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE STE 2120",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601180",
            "telephone_number": "770-423-0595",
            "fax_number": "678-391-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE STE 2120",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601180",
            "telephone_number": "770-423-0595",
            "fax_number": "678-391-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELES",
        "first_name": "JULIAN",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "GA",
            "license": "206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.