NPIMap

Organization Active NPI

Angelic Primary Medicine LLC

  • Adult Medicine Physician
  • Pleasantville, NJ
National Provider Identifier
1477199446
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
ANGELIC PRIMARY MEDICINE LLC
Practice address
8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Phone
(854) 600-9684
Fax
(609) 415-1875
NPI assigned
Nov 25, 2019
Last updated
Oct 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Authorized official

Name
Mrs. Janet Gibson, APNNPI 1043601156
Title
Owner/Director
Phone
(609) 515-4759

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NU
Primary Care Nurse Practitioner 363LP2300X NU
Adult Medicine Physician 207QA0505X NU Primary

Addresses

Primary practice location

8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967

Mailing address

PO Box 313
Linwood, NJ 08221-0313
Phone (854) 600-9684

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JGibson@clarityprimarymed.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191223000693 NJ Part B Supplier - Clinic/Group Practice 6103250345 Receives reassigned benefits from 9 practitioners
Practice locations: Pleasantville, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790812800000",
    "number": "1477199446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 313",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082210313",
            "telephone_number": "854-600-9684",
            "fax_number": "609-415-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8025 BLACK HORSE PIKE STE 501",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322967",
            "telephone_number": "854-600-9684",
            "fax_number": "609-415-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC PRIMARY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-25",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "609-515-4759",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JGibson@clarityprimarymed.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "8025 Black Horse Pike Ste 501",
            "city": "Pleasantville",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "082322967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pleasantville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.