Angela Brady, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95000669 Issued in CA

Practice address

1194 Buttercup Way
Beaumont, CA 92223-8480

Phone

(951) 849-5112

NPI assigned

Feb 8, 2014

Last updated

Apr 30, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• San Gorgonio Memorial Health Care District

  dba San Gorgonio Memorial Medical Clinic

  • Multi-Specialty Clinic/Center
  • Banning, CA
  • NPI 1194243642
  NPD Authorized official
• San Gorgonio Memorial Health Care District

  • Family Medicine Physician
  • Banning, CA
  • NPI 1801761358
  NPD Authorized official
• Premier Emergency Physicians of California Medical Group PC

  • Emergency Medicine Physician
  • Barstow, CA
  • NPI 1225289135
  NPD (past)
• Rainbow Basin Emergency Physicians, a Medical Corporation

  • Emergency Medicine Physician
  • Barstow, CA
  • NPI 1811148729
  NPD (past)

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

{
    "created_epoch": "1391817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1689098832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1194 BUTTERCUP WAY",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922238480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1194 BUTTERCUP WAY",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922238480",
            "telephone_number": "951-849-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "ANGELA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-08",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald Theadore Blackmon III
• Nicole Nadine Blizzard, MS, OTR/L
• Amanda Bojorquez, LCSW
• Clark Anthony Botha, BPHARM, RPH
• Matta Joseph Matta Botrous, D.D.S.
• Miranda Elizabeth Bravo Alkaddumi
• Michelle Marie Brilee, FNP-BC
• Sarah Elise Brownfield
• Mae Buenafe
• Henry Burciaga, MFT

• Family Nurse Practitioner in Beaumont, CA
• Providers in Beaumont, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.