Active NPI
Angelle P Lowery, PA-C
- Medical Physician Assistant
- Ocean Springs, MS
National Provider Identifier
1013966969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA069
- Practice address
- 1137 Ocean Springs Rd
Ocean Springs, MS 39564-3421 - Phone
- (228) 875-8291
- Fax
- (877) 504-3044
- NPI assigned
- May 9, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA069 | MS | Primary |
Addresses
Primary practice location
1137 Ocean Springs Rd
Ocean Springs, MS 39564-3421
Mailing address
1137 Ocean Springs Rd
Ocean Springs, MS 39564-3421
Phone (228) 875-8291
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1936776 | Medicaid | MS | |
| 203211285 | Other | MS | TAX IDENTIFICATION NUMBER |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA069 | MS | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Ear, Nose and Throat, Head and Neck Surgery Associates, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Gulfport, MS
- NPI 1366560435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1013966969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1137 OCEAN SPRINGS RD",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395643421",
"telephone_number": "228-875-8291",
"fax_number": "877-504-3044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1137 OCEAN SPRINGS RD",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395643421",
"telephone_number": "228-875-8291",
"fax_number": "877-504-3044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOWERY",
"first_name": "ANGELLE",
"middle_name": "P",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-09",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MS",
"license": "PA069",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1936776",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "203211285",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocean Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.