Angela Marie Appleman, O.D.

Individual provider Active NPI Optometrist · Rolla, MO

NPI 1447414040 · NPPES record last updated Jun 16, 2016

Key facts

NPI
1447414040
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
2015012017 (MO)
Practice address
1605 Martin Springs Dr
Ste 240 a
Rolla, MO 65401-2982
Phone
(573) 458-6310
NPI assigned
Jul 12, 2008
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Medical Group, LLC Past Accepting new patients
Low Country Eye Associates, PC Optometrist Past
since Jul 22, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2015012017 MO Yes
Optometrist 152W00000X OPT002473 GA

Addresses

Primary practice location

1605 Martin Springs Dr
Ste 240 a
Rolla, MO 65401-2982

Mailing address

PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620

Other identifiers

IdentifierTypeStateIssuer
PENDINGMedicaidMO

Other names

  • Angela Marie Vandyke Former name

Other providers in Rolla, MO

All providers in Rolla, MO · Optometrist in Missouri

Sources for this page

Verify at the official NPI Registry.