Individual provider Active NPI

Angela Peterson, RN

  • School Registered Nurse
  • Sunland Park, NM
National Provider Identifier
1861911141
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
920301 Issued in TX
Practice address
305 Alto Vista Dr
Sunland Park, NM 88063-9116
Phone
(575) 589-1110
NPI assigned
Sep 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 920301 TX Primary

Addresses

Primary practice location

305 Alto Vista Dr
Sunland Park, NM 88063-9116

Mailing address

PO Drawer 70
Anthony, NM 88021
Phone (575) 882-6101

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
920301TXMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gadsden Independent School District Past Accepting new patients
Gadsden Independent School District Past Accepting new patients

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": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1861911141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 70",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "88021",
            "telephone_number": "575-882-6101",
            "fax_number": "575-882-6926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ALTO VISTA DR",
            "city": "SUNLAND PARK",
            "state": "NM",
            "postal_code": "880639116",
            "telephone_number": "575-589-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANGELA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "TX",
            "license": "920301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunland Park, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; 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.