Individual provider Active NPI

Angela Brown, N.P

  • Adult Health Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1053554493
Registry record updated Apr 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2009002090 Issued in IL
Practice address
5911 Nebeshone LN
Rockford, IL 61103-8926
Phone
(815) 633-8099
NPI assigned
Apr 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2009002090 IL Primary

Addresses

Primary practice location

5911 Nebeshone LN
Rockford, IL 61103-8926

Mailing address

5911 Nebeshone LN
Rockford, IL 61103-8926
Phone (815) 633-8099

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2009002090ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LTC Medical Inc Past Accepting new patients
Hartman Health Services, P.C. PastSince Apr 8, 2009 Accepting new patients
In Home Medical Group LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239753600000",
    "number": "1053554493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 NEBESHONE LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611038926",
            "telephone_number": "815-633-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 NEBESHONE LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611038926",
            "telephone_number": "815-633-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "2009002090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; 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.