Individual provider Active NPI

Angelia Elizabeth Rickey, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Temple, TX
National Provider Identifier
1215658620
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1034803 Issued in TX
Practice address
304 S 22ND St
Temple, TX 76501-4726
Phone
(254) 298-7000
NPI assigned
Sep 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1034803 TX Primary

Addresses

Primary practice location

304 S 22ND St
Temple, TX 76501-4726

Mailing address

4135 N Rock Creek Loop
Waco, TX 76708-7032
Phone (254) 715-8821

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
I20221103003354 TX Practitioner - Nurse Practitioner 6305213315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

304 S 22ND St
Temple, TX 76501-4726
Phone (254) 778-4841

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1034803TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Counties Center for Mental Health & Mental Retardation SRVS CurrentSince Sep 29, 2022 Accepting new patients
Central Counties Center for Mental Health & Mental Retardation SRVS CurrentSince Sep 29, 2022 Accepting new patients

Locations

304 S 22nd St
Temple, TX 76501
Phone (254) 298-7000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1215658620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 N ROCK CREEK LOOP",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767087032",
            "telephone_number": "254-715-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S 22ND ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765014726",
            "telephone_number": "254-298-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKEY",
        "first_name": "ANGELIA",
        "middle_name": "ELIZABETH",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1034803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.