Angelia Mack

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP139916 Issued in TX

Practice address

4600 Taft Blvd
Wichita Falls, TX 76308-4935

Phone

(940) 696-1710

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Practice roles

Interoperability endpoints

• Direct secure messaging: amack@ansbi.directbygreenway.com

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.

• DHHS PHS Naihs Crownpoint Hospital

  • General Acute Care Hospital
  • Crownpoint, NM
  • NPI 1114960093

  TX

  Medicare reassignment NPD
• Pueblo Pintado Clinic

  • Clinic/Center
  • Cuba, NM
  • NPI 1023051133
  NPD
• Thoreau Clinic

  • Clinic/Center
  • Thoreau, NM
  • NPI 1679516702
  NPD

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1356812416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 LONGVIEW ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763064648",
            "telephone_number": "210-232-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 TAFT BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763084935",
            "telephone_number": "940-696-1710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1403 Longview St",
            "address_purpose": "LOCATION",
            "city": "Wichita Falls",
            "state": "TX",
            "postal_code": "763064648",
            "country_code": "US",
            "telephone_number": "210-232-1880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "ANGELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP139916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000000000000000000",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonie Gene Lyon, APRN, FNP-BC
• William Lyons, LAT, ATC
• M D M Home Medical Equipment, LLC
• M S Young Enterprises LLC
• Brina-Quin Louise Macgibbon, RN
• Stacia Renee Macleod
• Madden Counseling
• Arthur John Madden, M.ED., LPC
• Daniel J Madden, M.A., LPC
• Michelle M. Madden, M.A., LPC

• Nurse Practitioner in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.