Individual provider Active NPI

Angelline Opal Blackwood, ARNP

  • Nurse Practitioner
  • Wellington, FL
National Provider Identifier
1346785987
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9235172 Issued in FL
Practice address
2585 S State Road 7
Suite 110
Wellington, FL 33414-9323
Phone
(561) 795-8655
Fax
(561) 795-8449
NPI assigned
Jan 5, 2017
Last updated
Jan 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9235172 FL Primary

Addresses

Primary practice location

2585 S State Road 7
Suite 110
Wellington, FL 33414-9323

Mailing address

2585 S State Road 7
Suite 110
Wellington, FL 33414-9323
Phone (561) 795-8655

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

LicenseStateTypeSpecialty
ARNP9235172FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pain Care of South Florida LLC PastSince Apr 12, 2010 Accepting new patients
Comprehensive Pain Care of S FL Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1346785987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 S STATE ROAD 7",
            "address_2": "SUITE 110",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334149323",
            "telephone_number": "561-795-8655",
            "fax_number": "561-795-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 S STATE ROAD 7",
            "address_2": "SUITE 110",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334149323",
            "telephone_number": "561-795-8655",
            "fax_number": "561-795-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "ANGELLINE",
        "middle_name": "OPAL",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9235172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.