Individual provider Active NPI

Angela Jones

  • Family Nurse Practitioner
  • Magnolia, AR
National Provider Identifier
1922474014
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004455 Issued in AR
Practice address
207 S Jefferson
Magnolia, AR 71753-3901
Phone
(870) 235-3798
NPI assigned
Aug 12, 2015
Last updated
Mar 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP08437 LA
Family Nurse Practitioner 363LF0000X A004455 AR Primary

Addresses

Primary practice location

207 S Jefferson
Magnolia, AR 71753-3901

Mailing address

207 S Jefferson
Magnolia, AR 71753-3901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20160331000359 AR Practitioner - Nurse Practitioner 2365749603 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Arkansas Department of Health Payroll OfficeGroup PAC ID 5799696779, 28 clinicians

Practice addresses (Care Compare)

4815 W Markham St
Little Rock, AR 72205-3866
Phone (501) 661-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP08437LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Arkansas Emergency Physicians, LLP CurrentSince Jan 1, 2017 Accepting new patients
South Arkansas Emergency Physicians LLP Current Accepting new patients
South Arkansas Emergency Physicians, LLP CurrentSince Jan 1, 2017 Accepting new patients

Locations

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

Organizations & group practices 4

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": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1922474014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S JEFFERSON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717533901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S JEFFERSON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717533901",
            "telephone_number": "870-235-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08437",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, AR

Sources for this page

Verify at the official NPI Registry.