Individual provider Active NPI

Angela Mattingly, PHARMD

  • Pharmacist
  • Indianapolis, IN
National Provider Identifier
1902273287
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26026066A Issued in IN
Practice address
26 N Arsenal Ave
Indianapolis, IN 46201-3808
Phone
(317) 632-0123
Fax
(317) 423-0608
NPI assigned
Aug 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26026066A IN Primary

Addresses

Primary practice location

26 N Arsenal Ave
Indianapolis, IN 46201-3808

Mailing address

26 N Arsenal Ave
Indianapolis, IN 46201-3808
Phone (317) 632-0123

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
26026066AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1902273287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 N ARSENAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462013808",
            "telephone_number": "317-632-0123",
            "fax_number": "317-423-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 N ARSENAL AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462013808",
            "telephone_number": "317-632-0123",
            "fax_number": "317-423-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "ANGELA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26026066A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; 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.