NPIMap

Individual provider Active NPI

Angela Ivy, APRN

  • Family Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1598114332
Registry record updated Jun 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004747 Issued in AR
Practice address
201 E Oak Ave
Jonesboro, AR 72401-4163
Phone
(870) 935-6729
NPI assigned
Jun 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A004747 AR Primary

Addresses

Primary practice location

201 E Oak Ave
Jonesboro, AR 72401-4163

Mailing address

201 E Oak Ave
Jonesboro, AR 72401-4163
Phone (870) 935-6729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031002181 AR Practitioner - Nurse Practitioner 0547548208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Physician Clinics IncGroup PAC ID 7012311269, 211 clinicians

Practice addresses (Care Compare)

1005 E Matthews Ave
Jonesboro, AR 72401-4308
Phone (870) 935-1242

1007 E Matthews Ave
Jonesboro, AR 72401-4308
Phone (870) 336-0472

1309 W Main St
Walnut Ridge, AR 72476-1430
Phone (870) 935-6729

1995 Hwy 62 412
Highland, AR 72542-9262
Phone (870) 935-6729

201 E Oak Ave
Jonesboro, AR 72401-4163
Phone (870) 935-6729

4000 Linwood Dr
Suite B
Paragould, AR 72450-7224
Phone (870) 565-1200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Physician Clinics, Inc. CurrentSince Mar 1, 2024 Accepting new patients
St Bernards Physician Clinics Inc CurrentSince Mar 1, 2024 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients

Locations

1995 Highway 62 412
Highland, AR 72542
Phone (870) 856-4325

1005 E Matthews Ave
Jonesboro, AR 72401
Phone (870) 935-1242

201 E Oak Ave
Jonesboro, AR 72401

Interoperability endpoints

  • Direct secure messaging: anivy@sbpc.medalliesdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1465603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465603200000",
    "number": "1598114332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E OAK AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014163",
            "telephone_number": "870-935-6729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E OAK AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014163",
            "telephone_number": "870-935-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "ANGELA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-11",
        "last_updated": "2016-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.