Active NPI
Angela Lynn Ward
- Developmental Disabilities Clinic/Center
- North Port, FL
National Provider Identifier
1295290625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Disabilities Clinic/Center
- License
- 101669300
- Practice address
- 1141 Dinsmore St
North Port, FL 34288-6844 - Phone
- (941) 769-0810
- NPI assigned
- Feb 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | 101669300 | FL | Primary |
Addresses
Primary practice location
1141 Dinsmore St
North Port, FL 34288-6844
Mailing address
1141 Dinsmore St
North Port, FL 34288-6844
Phone (941) 769-0810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101669300 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101669300 | FL | MD | Developmental Disabilities Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1295290625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 DINSMORE ST",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "342886844",
"telephone_number": "941-769-0810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 DINSMORE ST",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "342886844",
"telephone_number": "941-769-0810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARD",
"first_name": "ANGELA",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-11",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": "FL",
"license": "101669300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101669300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Port, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.