Individual provider Active NPI

Angela K Santiago, ARNP

  • Adult Health Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1477680593
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9217962 Issued in FL
Practice address
6420 NW 9TH Blvd
Gainesville, FL 32605-4203
Phone
(352) 331-2332
Fax
(352) 331-6515
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP9217962 FL Primary
General Practice Registered Nurse 163WG0000X RN9217962 FL

Addresses

Primary practice location

6420 NW 9TH Blvd
Gainesville, FL 32605-4203

Mailing address

6420 NW 9TH Blvd
Gainesville, FL 32605-4203
Phone (352) 331-2332

Other identifiers 1

IdentifierTypeStateIssuer
308900200MedicaidFL

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
I20070919000336 FL Practitioner - Nurse Practitioner 8123112323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Florida College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deardourff Timmons and Associates PA 4 clinicians

Practice addresses (Care Compare)

6420 NW 9TH Blvd
Suite 2
Gainesville, FL 32605-4203
Phone (352) 331-2332

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9217962FLMDGeneral Practice Registered Nurse
ARNP9217962FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deardourff Timmons & Associates PA CurrentSince Apr 1, 2015 Accepting new patients

Locations

6420 NW 9th Blvd
Ste 2
Gainesville, FL 32605
Phone (352) 331-2332

6420 NW 9th Blvd
Gainesville, FL 32605
Phone (352) 331-2332

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1477680593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 NW 9TH BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054203",
            "telephone_number": "352-331-2332",
            "fax_number": "352-331-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 NW 9TH BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054203",
            "telephone_number": "352-331-2332",
            "fax_number": "352-331-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "ANGELA",
        "middle_name": "K",
        "name_prefix": "Miss",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9217962",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "RN9217962",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308900200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.