Angela Phares

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

440126 Issued in OH

Practice address

178 Private Road 19423
South Point, OH 45680-8831

Phone

(740) 263-2626

Fax

(740) 894-1132

NPI assigned

Jul 11, 2017

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Montgomery General Hospital, IncGroup PAC ID 6204735269, shared by 5 NPIs, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mustard Seed Counseling and Behavioral Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Charleston, WV
  • NPI 1114633773
  Medicare reassignment NPD Authorized official
• Cornerstone Medical Group of West Virginia LLC

  • Family Medicine Physician
  • Green Bank, WV
  • NPI 1811877442
  NPD (past)

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1023530110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 PRIVATE ROAD 19423",
            "city": "SOUTH POINT",
            "state": "OH",
            "postal_code": "456808831",
            "telephone_number": "740-263-2626",
            "fax_number": "740-894-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 PRIVATE ROAD 19423",
            "city": "SOUTH POINT",
            "state": "OH",
            "postal_code": "456808831",
            "telephone_number": "740-263-2626",
            "fax_number": "740-894-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHARES",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "440126",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN70618NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peak Medical Associates LLC
• Brittaney Perkins
• Amber Nicole Perry, HHC, HHA
• Heidi Perry
• Nipuni Madara Pfeiffer
• Crysta Phipps
• Olivia Phipps
• Larry E Pierce
• David L Porter, RPH
• Taylor L Porter

• Family Nurse Practitioner in South Point, OH
• Providers in South Point, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.