Individual provider Active NPI

Angel Witcher

  • Nurse's Aide
  • Jonesboro, GA
National Provider Identifier
1013780162
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CN0030089405 Issued in GA
Practice address
3063 Drexel LN
Jonesboro, GA 30236-6847
Phone
(786) 741-6221
NPI assigned
Oct 31, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X CN0030089405 GA Primary

Addresses

Primary practice location

3063 Drexel LN
Jonesboro, GA 30236-6847

Mailing address

3063 Drexel LN
Jonesboro, GA 30236-6847
Phone (786) 741-6221

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
CN0030089405GAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1013780162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3063 DREXEL LN",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302366847",
            "telephone_number": "786-741-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3063 DREXEL LN",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302366847",
            "telephone_number": "786-741-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITCHER",
        "first_name": "ANGEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0030089405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.