Individual provider Active NPI

Angelique Brown

  • Women's Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1861108797
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
95033446 Issued in CA
Practice address
1520 Clifton Rd NE
Atlanta, GA 30322-4201
Phone
(404) 727-7980
NPI assigned
Jan 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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 RN316843 GA
Women's Health Nurse Practitioner 363LW0102X 95033446 CA Primary

Addresses

Primary practice location

1520 Clifton Rd NE
Atlanta, GA 30322-4201

Mailing address

1520 Clifton Rd NE
Atlanta, GA 30322-4201
Phone (404) 727-7980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251210003895 CA Order and Referring Only - Nurse Practitioner 3173017738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN316843GAMDRegistered Nurse
95033446CAMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1861108797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224201",
            "telephone_number": "404-727-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224201",
            "telephone_number": "404-727-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ANGELIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN316843",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95033446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.