Individual provider Active NPI

Angela G Fleming

  • Family Nurse Practitioner
  • Glen Allen, VA
National Provider Identifier
1841929148
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024185395 Issued in VA
Practice address
11201 Nuckols Rd
Glen Allen, VA 23059-5502
Phone
(804) 887-8322
Fax
(804) 877-8321
NPI assigned
Jun 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001178165 VA
Family Nurse Practitioner 363LF0000X 0024185395 VA Primary

Addresses

Primary practice location

11201 Nuckols Rd
Glen Allen, VA 23059-5502

Mailing address

PO Box 631863
Cincinnati, OH 45263-1863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20230615001430 VA Practitioner - Nurse Practitioner 4082072517 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001178165VAMDRegistered Nurse
0024185395VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coremedx Inc. CurrentSince Apr 27, 2023 Accepting new patients
Bon Secours Urgent Care LLC CurrentSince Nov 6, 2023 Accepting new patients

Locations

441 Piney Forest Rd
Ste G
Danville, VA 24540
Phone (434) 793-0700

9851 Brook Rd
Glen Allen, VA 23059
Phone (804) 893-8702

11201 Nuckols Rd
Glen Allen, VA 23059
Phone (804) 887-8322

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, 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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1841929148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631863",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 NUCKOLS RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595502",
            "telephone_number": "804-887-8322",
            "fax_number": "804-877-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "ANGELA",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001178165",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024185395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.