Active NPI
Angelique Shante Wells, RN
- Registered Nurse
- College Park, GA
National Provider Identifier
1952473555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN138524
- Practice address
- 1920 Johns Wesley Ave
College Park Regional Health Center
College Park, GA 30337 - Phone
- (404) 765-4155
- NPI assigned
- Nov 15, 2006
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN138524 | GA | Primary |
Addresses
Primary practice location
1920 Johns Wesley Ave
College Park Regional Health Center
College Park, GA 30337
Mailing address
99 Jesse Hill Jr Drive SE
Room 402
Atlanta, GA 30303
Phone (404) 730-1217
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN138524 | GA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952473555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 JESSE HILL JR DRIVE SE",
"address_2": "ROOM 402",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30303",
"telephone_number": "404-730-1217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 JOHNS WESLEY AVE",
"address_2": "COLLEGE PARK REGIONAL HEALTH CENTER",
"city": "COLLEGE PARK",
"state": "GA",
"postal_code": "30337",
"telephone_number": "404-765-4155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "ANGELIQUE",
"middle_name": "SHANTE",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN138524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.