Angela Bouton, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ01325000 Issued in NJ

Practice address

3350 State Route 138 Ste 117
Wall Township, NJ 07719-9694

Phone

(732) 280-2727

NPI assigned

Apr 11, 2022

Last updated

Jul 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angela.bouton.1@19096.direct.athenahealth.com

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.

• Vanitha Yadalla MD LLC

  • Internal Medicine Physician
  • Wall Township, NJ
  • NPI 1477919710

  Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1245972215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 STATE ROUTE 138 STE 117",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199694",
            "telephone_number": "732-280-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 STATE ROUTE 138 STE 117",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199694",
            "telephone_number": "732-280-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTON",
        "first_name": "ANGELA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NJ01325000",
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "NJ",
            "license": "26NJ01325000",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01325000",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01325000",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01325000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeana Therese Blakeslee
• Diane Bleiman
• Judith Ann Bosco
• Danielle Bosland, DPT
• Joseph Eli Bouganim, MD
• Brain Health Center
• Brandywine Senior Living at Wall
• Brandywine Senior Living at Wall
• Mariah E Bricker
• Heather Brown, OTR/L

• Nurse Practitioner in Wall Township, NJ
• Providers in Wall Township, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.