Active NPI
Angela Denise Dearman
- Family Nurse Practitioner
- Laurel, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 904408
- Practice address
- 811 N 2ND Ave
Laurel, MS 39440-3561 - Phone
- (601) 466-9921
- NPI assigned
- Sep 25, 2020
- Last updated
- Jun 30, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 904408 | MS | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
811 N 2ND Ave
Laurel, MS 39440-3561
Mailing address
811 N 2ND Ave
Laurel, MS 39440-3561
Phone (601) 466-9921
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
106 Asbury Cir
Hattiesburg, MS 39402-1302
Phone (601) 268-8698
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 904408 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grayson Creek Medical Clinic, LLC | Family | Current | Accepting new patients |
| Smith Audiology, LLC | Current | Accepting new patients | |
| Pain Consultants of South Mississippi PA | Current | Accepting new patients | |
| Arden Health LLC | Family | Current | Accepting new patients |
Locations
106 Asbury Cir
Hattiesburg, MS 39402
Phone (601) 264-6283
3 John Everett Rd
Moselle, MS 39459
Phone (601) 475-9304
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Organizations & group practices 4
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.
-
- Pain Medicine (Anesthesiology) Physician
- Hattiesburg, MS
- NPI 1619920584
-
- Family Nurse Practitioner
- Moselle, MS
- NPI 1821848045
-
- Audiologist
- Moselle, MS
- NPI 1619792785
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brookhaven, MS
- NPI 1972503464
-
- General Acute Care Hospital
- Laurel, MS
- NPI 1619973542
-
dba Merit Health Wesley
- General Acute Care Hospital
- Hattiesburg, MS
- NPI 1841241841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1326655168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 N 2ND AVE",
"city": "LAUREL",
"state": "MS",
"postal_code": "394403561",
"telephone_number": "601-466-9921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 N 2ND AVE",
"city": "LAUREL",
"state": "MS",
"postal_code": "394403561",
"telephone_number": "601-466-9921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEARMAN",
"first_name": "ANGELA",
"middle_name": "DENISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-25",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "904408",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Laurel, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.