Individual provider Active NPI

Angela Rotter, CRNP

  • Family Nurse Practitioner
  • Hoover, AL
National Provider Identifier
1720673015
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-123666 Issued in AL
Practice address
501 Emery Dr W
Hoover, AL 35244-4625
Phone
(205) 989-7254
Fax
(205) 989-4202
NPI assigned
Mar 8, 2021
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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 1-123666 AL Primary

Addresses

Primary practice location

501 Emery Dr W
Hoover, AL 35244-4625

Mailing address

801 Hillmoor LN
Homewood, AL 35209-6432

Other identifiers 1

IdentifierTypeStateIssuer
1-123666OtherALAL NURSING LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 205-989-4202 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210422000406 AL Practitioner - Nurse Practitioner 6103234695 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince May 1, 2021 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

501 Emery Dr W
Hoover, AL 35244
Phone (205) 801-7703

Organizations & group practices 1

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": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1720673015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 HILLMOOR LN",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352096432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 EMERY DR W",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444625",
            "telephone_number": "205-989-7254",
            "fax_number": "205-989-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTER",
        "first_name": "ANGELA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-123666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL NURSING LICENSE",
            "identifier": "1-123666",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "205-989-4202",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "501 Emery Dr W",
            "city": "Hoover",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352444625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

Verify at the official NPI Registry.