Individual provider Active NPI

Angela Ranae Hawk, APRN,PNP-C

  • Pediatric Nurse Practitioner
  • Alliance, NE
National Provider Identifier
1285076653
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
111542 Issued in NE
Practice address
204 E 3Rd St
Alliance, NE 69301-3826
Phone
(308) 761-1151
Fax
(308) 761-1139
NPI assigned
Jul 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 111542 NE Primary

Addresses

Primary practice location

204 E 3Rd St
Alliance, NE 69301-3826

Mailing address

204 E 3Rd St
PO Box 646
Alliance, NE 69301-3826
Phone (308) 761-1151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20140311001698 NE Practitioner - Nurse Practitioner 3779713839 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111542NEMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan's Boys' Home Pediatrics CurrentSince May 26, 2017 Accepting new patients
Alliance Children's & Allied Health, Inc. Pediatrics CurrentSince Dec 8, 2013 Accepting new patients
ENT Services PC Past Accepting new patients

Locations

204 E 3rd St
Alliance, NE 69301
Phone (308) 761-1151

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1285076653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 3RD ST",
            "address_2": "PO BOX 646",
            "city": "ALLIANCE",
            "state": "NE",
            "postal_code": "693013826",
            "telephone_number": "308-761-1151",
            "fax_number": "308-761-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E 3RD ST",
            "city": "ALLIANCE",
            "state": "NE",
            "postal_code": "693013826",
            "telephone_number": "308-761-1151",
            "fax_number": "308-761-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWK",
        "first_name": "ANGELA",
        "middle_name": "RANAE",
        "name_prefix": "Mrs.",
        "credential": "APRN,PNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NE",
            "license": "111542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, NE

Sources for this page

Verify at the official NPI Registry.