Individual provider Active NPI

Angela Sue Bennett, ARNP

  • Family Nurse Practitioner
  • Moses Lake, WA
National Provider Identifier
1932478641
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP 60262315 Issued in WA
Practice address
801 E Wheeler Rd
Moses Lake, WA 98837-1820
Phone
(509) 765-5606
NPI assigned
Dec 26, 2011
Last updated
May 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP 60262315 WA Primary

Addresses

Primary practice location

801 E Wheeler Rd
Moses Lake, WA 98837-1820

Mailing address

660 S Coolidge St
Moses Lake, WA 98837-1872
Phone (509) 793-9715

Other practice location 1

1550 S Pioneer Way
Moses Lake, WA 98837-4613
Phone (509) 793-9790

Other identifiers 1

IdentifierTypeStateIssuer
2016245MedicaidWA

Other names 1

  • Angela S Wilson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120425000690 WA Practitioner - Nurse Practitioner 2466614193 Reassigns benefits to 5 organizations
I20220119002959 AZ Practitioner - Nurse Practitioner 2466614193 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Em-I Medical Services PCGroup PAC ID 8325034812, 23 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP 60262315WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nextcare Arizona LLC CurrentSince Jun 7, 2022 Accepting new patients
Nextcare Arizona I JV LLC Current Accepting new patients
North Sound Emergency Medicine PC CurrentSince Jan 1, 2016 Accepting new patients
Arizona Em-I Medical Services PC Nurse Practitioner CurrentSince Feb 18, 2022 Accepting new patients
Multicare Health System Nurse Practitioner CurrentSince May 7, 2012 Accepting new patients
Multicare Health System CurrentSince May 7, 2012 Accepting new patients
Multicare Health System Current Accepting new patients
Kittitas Valley Urgent Care PLLC CurrentSince Jun 1, 2020 Accepting new patients
Grant County Public Hospital District 1 CurrentSince Jul 17, 2020 Accepting new patients
Grant County Public Hospital District 1 Current Accepting new patients
Eastside Emergency Physicians PLLC Current Accepting new patients
Sound Physicians Emergency Medicine of Arizona, Inc. Nurse Practitioner CurrentSince Mar 15, 2023 Accepting new patients
Grant County Public Hospital District 1 CurrentSince Jul 17, 2020 Accepting new patients
Eastside Emergency Physicians, PLLC CurrentSince Apr 1, 2013 Accepting new patients

Locations

2080 W Southern Ave
Bldg A1
Apache Junction, AZ 85120
Phone (480) 985-0172

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

450 S Willard St
Ste 120
Cottonwood, AZ 86326
Phone (928) 634-2574

1000 N Humphreys St
Ste 104
Flagstaff, AZ 86001
Phone (928) 779-3844

1171 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3000

914 N Scottsdale Rd
Ste 104
Tempe, AZ 85288
Phone (480) 776-1620

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

9525 E Old Spanish Trl
Ste 101
Tucson, AZ 85748
Phone (520) 731-3666

11351 S Frontage Rd
Yuma, AZ 85367
Phone (928) 336-2000

1394 W 16th St
Yuma, AZ 85364
Phone (928) 539-0055

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

702 E Mountain View Ave
#1
Ellensburg, WA 98926
Phone (509) 968-5273

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1700 13th St
Everett, WA 98201
Phone (425) 252-0895

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1550 S Pioneer Way
Moses Lake, WA 98837
Phone (509) 793-9780

660 S Coolidge St
Moses Lake, WA 98837

801 E Wheeler Rd
Moses Lake, WA 98837
Phone (509) 765-5606

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 455-3600

17 E Valley Mall Blvd
Union Gap, WA 98903
Phone (509) 367-8733

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1324857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1932478641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371872",
            "telephone_number": "509-793-9715",
            "fax_number": "509-764-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E WHEELER RD",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371820",
            "telephone_number": "509-765-5606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 S Pioneer Way",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "988374613",
            "country_code": "US",
            "telephone_number": "509-793-9790",
            "fax_number": "509-764-3255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ANGELA",
        "middle_name": "SUE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-26",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP 60262315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016245",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "WILSON",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.