Individual provider Active NPI

Angela Marie Glass, FNP

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1952573719
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200681 Issued in NC
Practice address
3500 Bush St
Raleigh, NC 27609-7509
Phone
(919) 875-8150
Fax
(919) 875-9577
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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 200681 NC Primary

Addresses

Primary practice location

3500 Bush St
Raleigh, NC 27609-7509

Mailing address

3500 Bush St
Raleigh, NC 27609-7509
Phone (919) 875-8150

Other names 1

  • Miss Angela Marie Mannino Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130612000000 NC Practitioner - Nurse Practitioner 9830338466 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Associates of Raleigh, PA CurrentSince Jun 16, 2017 Accepting new patients
Denis I Becker MD PA Endocrinology, Diabetes & Metabolism CurrentSince Apr 24, 2013 Accepting new patients

Locations

3500 Bush St
Raleigh, NC 27609
Phone (919) 875-8150

2709 Blue Ridge Rd
Ste 320
Raleigh, NC 27607
Phone (919) 876-7692

Interoperability endpoints

  • Direct secure messaging: angela.glass@49412312072196.direct.elationemr.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1952573719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 BUSH ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097509",
            "telephone_number": "919-875-8150",
            "fax_number": "919-875-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 BUSH ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097509",
            "telephone_number": "919-875-8150",
            "fax_number": "919-875-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "200681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MANNINO",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.