Individual provider Active NPI

Angeline G Walker, FNP-C

  • Family Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1760050413
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0996564-NP Issued in CO
Practice address
3720 Sinton Rd Ste 104
Colorado Springs, CO 80907-5085
Phone
(719) 493-9555
NPI assigned
Jun 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN.0996564-NP CO Primary
Family Nurse Practitioner 363LF0000X RXN.0105646-NP CO

Addresses

Primary practice location

3720 Sinton Rd Ste 104
Colorado Springs, CO 80907-5085

Mailing address

3720 Sinton Rd Ste 104
Colorado Springs, CO 80907-5085
Phone (719) 493-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220726000741 CO Practitioner - Nurse Practitioner 2264813039 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RXN.0105646-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bundukamara Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

3720 Sinton Rd
Ste 104
Colorado Springs, CO 80907
Phone (719) 493-9555

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1760050413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 SINTON RD STE 104",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075085",
            "telephone_number": "719-493-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 SINTON RD STE 104",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809075085",
            "telephone_number": "719-493-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ANGELINE",
        "middle_name": "G",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0996564-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "RXN.0105646-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.