Individual provider Active NPI

Angela B Culpepper, ARNP, FNP, BC

  • Family Nurse Practitioner
  • Perry, FL
National Provider Identifier
1376787580
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP1188462 Issued in FL
Practice address
1702 S Jefferson St
Perry, FL 32348-5611
Phone
(855) 577-5437
Fax
(850) 838-2140
NPI assigned
May 1, 2009
Last updated
Mar 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP1188462 FL Primary

Addresses

Primary practice location

1702 S Jefferson St
Perry, FL 32348-5611

Mailing address

3317 NE Colin Kelly Hwy
Madison, FL 32340-5187
Phone (850) 973-0341

Other identifiers 1

IdentifierTypeStateIssuer
001157000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150930002551 FL Practitioner - Nurse Practitioner 5395053953 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP1188462FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southland EMS at Madison, PLLC CurrentSince Apr 13, 2018 Accepting new patients
Little Pine Pediatrics, PLLC Past Accepting new patients

Locations

224 NW Crane Ave
Madison, FL 32340
Phone (850) 253-1923

Interoperability endpoints

  • Direct secure messaging: angela.culpepper.1@28226.direct.athenahealth.com
  • Direct secure messaging: angelaculpepper@lpp.opdirect.net

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": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1376787580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 NE COLIN KELLY HWY",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323405187",
            "telephone_number": "850-973-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 S JEFFERSON ST",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323485611",
            "telephone_number": "855-577-5437",
            "fax_number": "850-838-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULPEPPER",
        "first_name": "ANGELA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "ARNP, FNP, BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-01",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP1188462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001157000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, FL

Sources for this page

Verify at the official NPI Registry.