Individual provider Active NPI

Angela Denice Imes, RN, BSN

  • Registered Nurse
  • Fort Bragg, NC
National Provider Identifier
1215121025
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
103193 Issued in NC
Practice address
Medical One Stop Room 12, Normandy Drive
Fort Bragg, NC 28310-0001
Phone
(910) 396-6243
Fax
(910) 396-6224
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 103193 NC Primary

Addresses

Primary practice location

Medical One Stop Room 12, Normandy Drive
Fort Bragg, NC 28310-0001

Mailing address

5817 Weatherford Rd
Fayetteville, NC 28303-2658
Phone (910) 864-2119

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
103193NCMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1215121025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5817 WEATHERFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283032658",
            "telephone_number": "910-864-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL ONE STOP ROOM 12, NORMANDY DRIVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-396-6243",
            "fax_number": "910-396-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMES",
        "first_name": "ANGELA",
        "middle_name": "DENICE",
        "name_prefix": "Mrs.",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "103193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; 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.