Individual provider Active NPI

Amber Rhea Bagwell, FNP-C

  • Family Nurse Practitioner
  • San Angelo, TX
National Provider Identifier
1104469907
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP143483 Issued in TX
Practice address
34 Buick St
San Angelo, TX 76901-4730
Phone
(325) 658-5339
Fax
(325) 947-1207
NPI assigned
Oct 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP143483 TX Primary

Addresses

Primary practice location

34 Buick St
San Angelo, TX 76901-4730

Mailing address

34 Buick St
San Angelo, TX 76901-4730
Phone (325) 658-5339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20201007002249 TX Practitioner - Nurse Practitioner 0042639288 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Esperanza Clinic IncGroup PAC ID 7416942933, 13 clinicians

Practice addresses (Care Compare)

34 Buick St
San Angelo, TX 76901-4730
Phone (325) 658-5339

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Human Services Commission CurrentSince Nov 1, 2022 Accepting new patients
Health and Human Services Commission CurrentSince Nov 1, 2022 Accepting new patients
Health and Human Services Commission Current Accepting new patients

Locations

2501 Maple St
Abilene, TX 79602
Phone (325) 692-4053

4001 Highway 36 S
Brenham, TX 77833
Phone (979) 277-1327

11640 US Highway 87 N
Carlsbad, TX 76934
Phone (325) 465-2312

Interoperability endpoints

  • Direct secure messaging: abagwell39257@shannonhealth.direct-ci.com

Organizations & group practices 4

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.

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": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1104469907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 BUICK ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769014730",
            "telephone_number": "325-658-5339",
            "fax_number": "325-947-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 BUICK ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769014730",
            "telephone_number": "325-658-5339",
            "fax_number": "325-947-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "AMBER",
        "middle_name": "RHEA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.