Individual provider Active NPI

Abigail Elizabeth Deangelis, APRN-CNM

  • Advanced Practice Midwife
  • Fayetteville, AR
National Provider Identifier
1740852110
Registry record updated Mar 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
525 N Garland Ave
Fayetteville, AR 72701-3110
Phone
(479) 575-4451
NPI assigned
Jul 14, 2021
Last updated
Mar 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X Primary
Midwife 176B00000X

Addresses

Primary practice location

525 N Garland Ave
Fayetteville, AR 72701-3110

Mailing address

525 N Garland Ave
Fayetteville, AR 72701-3110
Phone (501) 837-5176

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL PatWalkerHealthCenter

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230427001285 AR Practitioner - Certified Nurse Midwife (CNM) 3678978988 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas CurrentSince Feb 1, 2023 Accepting new patients

Locations

525 N Garland Ave
Fayetteville, AR 72701
Phone (479) 575-4451

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": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677974400000",
    "number": "1740852110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N GARLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727013110",
            "telephone_number": "501-837-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N GARLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727013110",
            "telephone_number": "479-575-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "ABIGAIL",
        "middle_name": "ELIZABETH",
        "credential": "APRN-CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PatWalkerHealthCenter",
            "affiliation": "N",
            "address_1": "525 N Garland Ave",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727013110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.