Active NPI
Angela Gale Groverman, PA-C
- Physician Assistant
- Jackson, CA
National Provider Identifier
1720084585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA15037
- Practice address
- 12140 New York Ranch Rd
Jackson, CA 95642-9407 - Phone
- (209) 257-2400
- Fax
- (209) 257-2403
- NPI assigned
- Jun 24, 2005
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA15037 | CA | Primary |
Addresses
Primary practice location
12140 New York Ranch Rd
Jackson, CA 95642-9407
Mailing address
PO Box 939
Angels Camp, CA 95222-0939
Phone (209) 754-6262
Other names 1
- Angela Gale Foster
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1720084585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 939",
"city": "ANGELS CAMP",
"state": "CA",
"postal_code": "952220939",
"telephone_number": "209-754-6262",
"fax_number": "866-205-8079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12140 NEW YORK RANCH RD",
"city": "JACKSON",
"state": "CA",
"postal_code": "956429407",
"telephone_number": "209-257-2400",
"fax_number": "209-257-2403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROVERMAN",
"first_name": "ANGELA",
"middle_name": "GALE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-24",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA15037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "FOSTER",
"middle_name": "GALE",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Jackson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.