Individual provider Active NPI

Angela Christina Davis, NP

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1679058614
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN185946 Issued in GA
Practice address
657 Hemlock St Ste 220
Macon, GA 31201-8311
Phone
(478) 741-7241
Fax
(478) 745-8932
NPI assigned
Sep 25, 2018
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN185946 GA Primary
Acute Care Nurse Practitioner 363LA2100X 11081 CT

Addresses

Primary practice location

657 Hemlock St Ste 220
Macon, GA 31201-8311

Mailing address

192 Camdale CT
McDonough, GA 30252-2305
Phone (478) 777-0450

Other names 1

  • Angela Christina Leggett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190725003830 GA Practitioner - Nurse Practitioner 5193051332 Reassigns benefits to 1 organization
I20221130002279 CT Practitioner - Nurse Practitioner 5193051332 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Single Specialty CurrentSince Nov 15, 2022 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Nov 15, 2022 Accepting new patients
Cogent Healthcare of Georgia PC Single Specialty CurrentSince Jul 1, 2021 Accepting new patients
NGX Lawrenceville Ga PC Single Specialty CurrentSince Jul 9, 2023 Accepting new patients

Locations

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

1470 Lawrenceville Hwy
Lawrenceville, GA 30044
Phone (678) 486-7777

3545 Highway 81 E
McDonough, GA 30252
Phone (678) 486-7777

Interoperability endpoints

  • Direct secure messaging: aleggett1260528@nychhc.direct-ci.com
  • Direct secure messaging: angelaleggett@trh.allscriptsdirect.net

Organizations & group practices 4

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": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1679058614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 CAMDALE CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302522305",
            "telephone_number": "478-777-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 HEMLOCK ST STE 220",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018311",
            "telephone_number": "478-741-7241",
            "fax_number": "478-745-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANGELA",
        "middle_name": "CHRISTINA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN185946",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "11081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "LEGGETT",
            "middle_name": "CHRISTINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.