Individual provider Active NPI

Angelin Barker Comer

  • Family Nurse Practitioner
  • South Boston, VA
National Provider Identifier
1245636208
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024174922 Issued in VA
Practice address
101 Aubreys Loop
South Boston, VA 24592-5054
Phone
(434) 517-3879
NPI assigned
Nov 18, 2014
Reactivated
Feb 6, 2020
Last updated
Sep 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024174922 VA Primary

Addresses

Primary practice location

101 Aubreys Loop
South Boston, VA 24592-5054

Mailing address

101 Aubreys Loop
South Boston, VA 24592-5054
Phone (434) 517-3879

Other practice location 1

2054 Watson Blvd
Warner Robins, GA 31093-3634
Phone (478) 918-0770

Other names 1

  • Angelin Jordan Barker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20170731000633 VA Practitioner - Nurse Practitioner 2769700186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halifax Regional Hospital IncGroup PAC ID 4587572805, 27 clinicians

Practice addresses (Care Compare)

101 Aubreys Loop
South Boston, VA 24592-5054
Phone (434) 517-8627

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Medical Associates, LLC Current Accepting new patients
Halifax Regional Hospital, Inc CurrentSince Jan 1, 2021 Accepting new patients
Halifax Regional Hospital, Inc. CurrentSince Jan 1, 2021 Accepting new patients

Locations

2054 Watson Blvd
Warner Robins, GA 31093
Phone (478) 918-0770

15210 L P Bailey Memorial Hwy
Nathalie, VA 24577
Phone (434) 349-3113

101 Aubreys Loop
South Boston, VA 24592
Phone (434) 517-3879

2204 Wilborn Ave
South Boston, VA 24592
Phone (434) 517-3100

Interoperability endpoints

  • Direct secure messaging: acomer524311@direct.sentara.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1245636208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AUBREYS LOOP",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245925054",
            "telephone_number": "434-517-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AUBREYS LOOP",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245925054",
            "telephone_number": "434-517-3879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2054 Watson Blvd",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310933634",
            "country_code": "US",
            "telephone_number": "478-918-0770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMER",
        "first_name": "ANGELIN",
        "middle_name": "BARKER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "deactivation_date": "2020-01-07",
        "reactivation_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELIN",
            "last_name": "BARKER",
            "middle_name": "JORDAN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.