Individual provider Active NPI

Angela Renee Wright, ARNP-CNP

  • Primary Care Nurse Practitioner
  • Durant, OK
National Provider Identifier
1043443062
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
82743 Issued in OK
Practice address
702 Bryan Dr Ste 100
Durant, OK 74701-7031
Phone
(580) 924-4704
Fax
(580) 924-6001
NPI assigned
Aug 25, 2009
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R0082743 OK
Emergency Registered Nurse 163WE0003X 735995 TX
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP118767 TX
Student in an Organized Health Care Education/Training Program 390200000X 735995 TX
Primary Care Nurse Practitioner 363LP2300X 82743 OK Primary

Addresses

Primary practice location

702 Bryan Dr Ste 100
Durant, OK 74701-7031

Mailing address

702 Bryan Dr Ste 100
Durant, OK 74701-7031
Phone (580) 924-4704

Other names 1

  • Ms. Angela Renee Wright Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20110531000684 OK Practitioner - Nurse Practitioner 5698805273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jaiswal Clinic PLLCGroup PAC ID 4385717586, 2 clinicians

Practice addresses (Care Compare)

702 Bryan Dr
Suite 100
Durant, OK 74701-7031
Phone (580) 924-4704

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0082743OKMDRegistered Nurse
AP118767TXMDFamily Nurse Practitioner
82743OKMDPrimary Care Nurse Practitioner
735995TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Jaiswal Clinic PLLC Single Specialty CurrentSince May 9, 2022 Accepting new patients
Texas Em-1 Medical Services PA Single Specialty Past Accepting new patients

Locations

702 Bryan Dr
Ste 100
Durant, OK 74701
Phone (580) 924-4704

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEIEAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FEIEAA/Endpoint/FEIEAA

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1043443062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 BRYAN DR STE 100",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747017031",
            "telephone_number": "580-924-4704",
            "fax_number": "580-924-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BRYAN DR STE 100",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747017031",
            "telephone_number": "580-924-4704",
            "fax_number": "580-924-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "ARNP-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0082743",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TX",
            "license": "735995",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP118767",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "735995",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "82743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "WRIGHT",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "NP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Durant, OK

Sources for this page

Verify at the official NPI Registry.