NPIMap

Angela Christine Middleton, FNP-BC, CEN

Individual provider Active NPI Family Nurse Practitioner · Rolla, MO

NPI 1124382593 · NPPES record last updated Aug 22, 2019

Key facts

NPI
1124382593
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
2012007171 (MO)
Practice address
1000 W 10TH St
Rolla, MO 65401-2905
Phone
(573) 458-8899
NPI assigned
Jun 29, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 24

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Mississippi Medical Center, Inc. (361 clinicians)

Practice addresses (Care Compare)

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-3000

Hospital & facility affiliations

  • North Mississippi Medical Center Hospital · Tupelo, MS · CCN 250004

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MO, MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20121228000315 MO Practitioner - Nurse Practitioner 3971756875 Reassigns benefits to 1 organization
I20171213001009 MS Practitioner - Nurse Practitioner 3971756875 Reassigns benefits to 4 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2012007171MOMDFamily Nurse Practitioner
0024169754VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Potosi Emergency Group, LLC Current
since Mar 13, 2023		 Accepting new patients
North Mississippi Medcial Center, Inc. Current
since Mar 24, 2021		 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Current
since Nov 7, 2017		 Accepting new patients
Pontotoc Health Services, Inc. Current Accepting new patients
North Mississippi Medical Center Inc Current
since Mar 24, 2021		 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Pontotoc Health Services, Inc. Current
since Feb 1, 2019		 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Current Accepting new patients
North Mississippi Medical Clinics Inc Family Current Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Clinics Inc Current
since Feb 7, 2022		 Accepting new patients
North Mississippi Medical Clinics Inc Current
since Feb 7, 2022		 Accepting new patients
Amory Surgery Clinic, PLLC Past Accepting new patients
North Mississippi Medical Center Past Accepting new patients
North Mississippi Medical Center, Inc. Family Past Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients

Locations

300 Health Way Dr
Potosi, MO 63664
Phone (573) 438-2977

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510

4381 S Eason Blvd
Ste 302
Tupelo, MS 38801
Phone (662) 377-5700

4381 S Eason Blvd
Ste 101
Tupelo, MS 38801
Phone (662) 377-4054

408 Council Cir
Ste B
Tupelo, MS 38801
Phone (662) 377-3008

4381 S Eason Blvd
Ste 301
Tupelo, MS 38801
Phone (662) 377-3008

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: angelamiddleton@nmhs.medalliesdirect.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024169754 VA
Family Nurse Practitioner 363LF0000X 2012007171 MO Yes

Addresses

Primary practice location

1000 W 10TH St
Rolla, MO 65401-2905

Mailing address

1050 W 10TH St
Attn: Executive Director of Physician Clincs
Rolla, MO 65401-2905
Phone (573) 364-9000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2019.

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1124382593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "address_2": "ATTN: EXECUTIVE DIRECTOR OF PHYSICIAN CLINCS",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000",
            "fax_number": "573-426-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-458-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "ANGELA",
        "middle_name": "CHRISTINE",
        "credential": "FNP-BC, CEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169754",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012007171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

All providers in Rolla, MO · Family Nurse Practitioner in Missouri

Sources for this page

Verify at the official NPI Registry.