Active NPI
Angelia Gaye Andrews, MD
- Family Medicine Physician
- Altus, OK
National Provider Identifier
1871531707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 22072
- Practice address
- 205 S Park LN
Altus, OK 73521-5755 - Phone
- (580) 379-6650
- Fax
- (580) 379-6659
- NPI assigned
- Jun 3, 2006
- Last updated
- Oct 4, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 22072 | OK | Primary |
Addresses
Primary practice location
205 S Park LN
Altus, OK 73521-5755
Mailing address
1200 E Pecan St
Altus, OK 73521-6141
Phone (580) 379-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01103919 | Other | RAILROAD MEDICARE | |
| 100113760D | Medicaid | OK |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22072 | OK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson County Memorial Hosp Phcy | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Jackson County Memorial Hospital Pharmacy
- Institutional Pharmacy
- Altus, OK
- NPI 1518028380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1871531707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 E PECAN ST",
"city": "ALTUS",
"state": "OK",
"postal_code": "735216141",
"telephone_number": "580-379-5000",
"fax_number": "580-379-5509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S PARK LN",
"city": "ALTUS",
"state": "OK",
"postal_code": "735215755",
"telephone_number": "580-379-6650",
"fax_number": "580-379-6659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDREWS",
"first_name": "ANGELIA",
"middle_name": "GAYE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-03",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "22072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01103919",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100113760D",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Altus, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.