Active NPI
Angela Lee Bodungen
- Pharmacist
- Metairie, LA
National Provider Identifier
1588956510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18609
- Practice address
- 1805 Metairie Ave
Metairie, LA 70005-3860 - Phone
- (504) 835-6467
- Fax
- (504) 835-9498
- NPI assigned
- May 10, 2011
- Last updated
- May 10, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18609 | LA | Primary |
Addresses
Primary practice location
1805 Metairie Ave
Metairie, LA 70005-3860
Mailing address
1805 Metairie Ave
Metairie, LA 70005-3860
Phone (504) 835-6467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 222ROSE | Medicaid | LA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18609 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Slaughter Drug Store | Past | Accepting new patients | |
| Slaughter Drug Store LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304985600000",
"number": "1588956510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 METAIRIE AVE",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700053860",
"telephone_number": "504-835-6467",
"fax_number": "504-835-9498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 METAIRIE AVE",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700053860",
"telephone_number": "504-835-6467",
"fax_number": "504-835-9498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODUNGEN",
"first_name": "ANGELA",
"middle_name": "LEE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-10",
"last_updated": "2011-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "18609",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "222ROSE",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.