Individual provider Active NPI

Angelo Andre Bagramyan, RN, BSN, PHN

  • Registered Nurse
  • Canyon Country, CA
National Provider Identifier
1841698479
Registry record updated Dec 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
780512 Issued in CA
Practice address
16647 Nearview Dr
Canyon Country, CA 91387-1733
Phone
(818) 624-1527
NPI assigned
Dec 13, 2014
Last updated
Dec 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 780512 CA Primary

Addresses

Primary practice location

16647 Nearview Dr
Canyon Country, CA 91387-1733

Mailing address

16647 Nearview Dr
Canyon Country, CA 91387-1733
Phone (818) 624-1527

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)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
780512CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Aeon Hospice Inc Current Accepting new patients
Lucas Health Partners, LLC Current Accepting new patients
Lucas Health Partners LLC Current Accepting new patients

Organizations & group practices 3

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": "1418428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418428800000",
    "number": "1841698479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16647 NEARVIEW DR",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913871733",
            "telephone_number": "818-624-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16647 NEARVIEW DR",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913871733",
            "telephone_number": "818-624-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGRAMYAN",
        "first_name": "ANGELO",
        "middle_name": "ANDRE",
        "credential": "RN, BSN, PHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-13",
        "last_updated": "2014-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "780512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Country, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.