Individual provider Active NPI

Angela Renee Vanmatre, FNP

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1639739469
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F06190446 Issued in IN
Practice address
12100 Highway 41 N Ste 1
Evansville, IN 47725-7032
Phone
(812) 868-7440
NPI assigned
Jun 14, 2019
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F06190446 IN Primary

Addresses

Primary practice location

12100 Highway 41 N Ste 1
Evansville, IN 47725-7032

Mailing address

PO Box 1738
Vincennes, IN 47591-7738
Phone (812) 396-9863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190715000732 IN Practitioner - Nurse Practitioner 0840525770 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Home Care Services LLCGroup PAC ID 4385961093, 101 clinicians

Practice addresses (Care Compare)

9775 Crosspoint Blvd
Suite 118
Indianapolis, IN 46256-3376
Phone (317) 588-3067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F06190446INMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Home Care Services, LLC CurrentSince Aug 27, 2023 Accepting new patients
Great Health Medical in PC CurrentSince Jun 7, 2025 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Aug 27, 2023 Accepting new patients

Locations

1345 N Madison Ave
Anderson, IN 46011
Phone (765) 644-2888

9775 Crosspoint Blvd
Ste 118
Indianapolis, IN 46256
Phone (317) 381-0095

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

407 Willoughby Ave
Brooklyn, NY 11205
Phone (212) 201-1252

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, 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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1639739469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1738",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475917738",
            "telephone_number": "812-396-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 HIGHWAY 41 N STE 1",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477257032",
            "telephone_number": "812-868-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANMATRE",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "F06190446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.