Individual provider Active NPI

Angela Marie Douglas, RPH

  • Pharmacist
  • Jasper, IN
National Provider Identifier
1588265300
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26016735A Issued in IN
Practice address
4040 N Newton St
Jasper, IN 47546-2575
Phone
(812) 634-1777
Fax
(812) 634-9810
NPI assigned
Nov 6, 2020
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26016735A IN Primary

Addresses

Primary practice location

4040 N Newton St
Jasper, IN 47546-2575

Mailing address

4040 N Newton St
Jasper, IN 47546-2575
Phone (812) 634-1777

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
26016735AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1588265300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 N NEWTON ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462575",
            "telephone_number": "812-634-1777",
            "fax_number": "812-634-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N NEWTON ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462575",
            "telephone_number": "812-634-1777",
            "fax_number": "812-634-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26016735A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.