Active NPI
Angela K Santiago, ARNP
- Adult Health Nurse Practitioner
- Gainesville, FL
National Provider Identifier
1477680593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- ARNP9217962
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 308900200 | Medicaid | FL |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN9217962 | FL | MD | General Practice Registered Nurse |
| ARNP9217962 | FL | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deardourff Timmons & Associates PA | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.