Individual provider Active NPI

Angella Tamanda Takomana, LVN

  • Licensed Vocational Nurse
  • Bedford, TX
National Provider Identifier
1134620578
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
309173 Issued in TX
Practice address
1908 Park Place Blvd Apt 816
Bedford, TX 76021-7501
Phone
(972) 551-9807
NPI assigned
Feb 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 309173 TX Primary

Addresses

Primary practice location

1908 Park Place Blvd Apt 816
Bedford, TX 76021-7501

Mailing address

1908 Park Place Blvd Apt 816
Bedford, TX 76021-7501
Phone (972) 551-9807

Other identifiers 1

IdentifierTypeStateIssuer
309173MedicaidTX

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
309173TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1134620578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 PARK PLACE BLVD APT 816",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760217501",
            "telephone_number": "972-551-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 PARK PLACE BLVD APT 816",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760217501",
            "telephone_number": "972-551-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKOMANA",
        "first_name": "ANGELLA",
        "middle_name": "TAMANDA",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "309173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309173",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.