Active NPI
Angela Michelle Jones, PHD
- Psychologist
- Bentonville, AR
National Provider Identifier
1497063432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 15-19P
- Practice address
- 1003 SE 14TH St Ste 4
Bentonville, AR 72712-6897 - Phone
- (479) 408-3200
- Fax
- (479) 358-1430
- NPI assigned
- Sep 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 15-19P | AR | Primary |
Addresses
Primary practice location
1003 SE 14TH St Ste 4
Bentonville, AR 72712-6897
Mailing address
1003 SE 14TH St Ste 4
Bentonville, AR 72712-6897
Phone (479) 408-3200
Other names 1
- Angela Michelle Bodling
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2023 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-19P | AR | MD | Psychologist |
Interoperability endpoints
- ajones217221@directc.mercy.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657843200000",
"number": "1497063432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1003 SE 14TH ST STE 4",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727126897",
"telephone_number": "479-408-3200",
"fax_number": "479-358-1430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 SE 14TH ST STE 4",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727126897",
"telephone_number": "479-408-3200",
"fax_number": "479-358-1430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "ANGELA",
"middle_name": "MICHELLE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-23",
"last_updated": "2022-07-15",
"certification_date": "2022-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AR",
"license": "15-19P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "BODLING",
"middle_name": "MICHELLE",
"credential": "PHD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.