NPIMap

Individual provider Active NPI

Angela L Bazemore Quaye, DBH, CFNC, RDMS, SAP

  • Sonography Radiologic Technologist
  • Peoria, AZ
National Provider Identifier
1194257758
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Radiologic TechnologistTaxonomy code 2471S1302X
License
108395 Issued in MD
Practice address
29697 N 69TH Dr
Peoria, AZ 85383-3178
Phone
(443) 636-0686
Fax
(602) 532-7857
NPI assigned
Mar 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Sonography Radiologic Technologist 2471S1302X 108395 MD Primary

Addresses

Primary practice location

29697 N 69TH Dr
Peoria, AZ 85383-3178

Mailing address

29697 N 69TH Dr
Peoria, AZ 85383-3178
Phone (443) 636-0686

Other identifiers 1

IdentifierTypeStateIssuer
814313295MedicaidAZ

Other names 1

  • Angela L Bazemore Former name

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
108395MDMDSonography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ezed-Q LLC Current Accepting new patients
Quayle Home Care Current Accepting new patients
Quayle Interventional Services LLC Current Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1194257758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29697 N 69TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833178",
            "telephone_number": "443-636-0686",
            "fax_number": "602-532-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29697 N 69TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833178",
            "telephone_number": "443-636-0686",
            "fax_number": "602-532-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZEMORE QUAYE",
        "first_name": "ANGELA",
        "middle_name": "L",
        "credential": "DBH, CFNC, RDMS, SAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "MD",
            "license": "108395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "814313295",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "BAZEMORE",
            "middle_name": "L",
            "credential": "DBH, CFNC, RDMS, SAP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.