Angela Linda Graves, APN

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

A02971 ANP Issued in AR

Practice address

4077 Jefferson Ave
Texarkana, AR 71854-1509

Phone

(870) 330-9200

Fax

(870) 330-9439

NPI assigned

Dec 19, 2006

Last updated

Aug 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Texas Border Health ClinicGroup PAC ID 8820038565, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• East Texas Border Health Clinic

  dba Genesis PrimeCare

  • Federally Qualified Health Center (FQHC)
  • Texarkana, AR
  • NPI 1093186249
  Medicare reassignment Care Compare group NPD
• Arkansas Health Group

  dba Arkansas Perinatal Services

  • Specialist
  • Little Rock, AR
  • NPI 1932429594
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  Medicare reassignment NPD
• Arkansas Health Group

  dba Baptist Health Surgical Clinic-Stuttgart

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD
• East Texas Border Health Clinic

  dba Genesis PrimeCare

  • Federally Qualified Health Center (FQHC)
  • Texarkana, AR
  • NPI 1548745383
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• East Texas Border Health Clinic

  dba Genesis Primecare

  • Federally Qualified Health Center (FQHC)
  • Texarkana, TX
  • NPI 1598366718
  NPD
• East Texas Border Health Clinic

  dba Genesis PrimeCare Pharmacy Marshall

  • Community/Retail Pharmacy
  • Marshall, TX
  • NPI 1073485082
  NPD (past)
• East Texas Border Health Clinic

  dba Genesis PrimeCare

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1700134996
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1932262995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1326",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756711326",
            "telephone_number": "903-927-3782",
            "fax_number": "903-927-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 JEFFERSON AVE",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718541509",
            "telephone_number": "870-330-9200",
            "fax_number": "870-330-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "ANGELA",
        "middle_name": "LINDA",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "562258",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AR",
            "license": "A02971 ANP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "A002971",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria M Gonzalez
• Coleman Gordon, MHPP
• Mary Gayle Gordon, MS
• Edythe Graham, MHPP
• Allee Grant, MHPP
• Aaron W Green, RN
• Danielle Green
• Rustin Green
• Tara L Green, MHPP
• Beverly J Greer-Simpson, M.D.

• Women's Health Nurse Practitioner in Texarkana, AR
• Providers in Texarkana, AR by specialty
• Women's Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.