Individual provider Active NPI

Angella M John, ARNP

  • General Practice Physician
  • Deerfield Beach, FL
National Provider Identifier
1962886705
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
APRN9212723 Issued in FL
Practice address
10 Fairway Dr Ste 305
Deerfield Beach, FL 33441-1802
Phone
(954) 744-0020
Fax
(754) 318-6211
NPI assigned
Jul 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X APRN9212723 FL
General Practice Physician 208D00000X APRN9212723 FL Primary

Addresses

Primary practice location

10 Fairway Dr Ste 305
Deerfield Beach, FL 33441-1802

Mailing address

10 Fairway Dr Ste 305
Deerfield Beach, FL 33441-1802
Phone (954) 744-0020

Other identifiers 1

IdentifierTypeStateIssuer
APRN9212723OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160125002547 FL Practitioner - Nurse Practitioner 4082917042

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9212723FLMDGeneral Practice Physician

Interoperability endpoints

  • Direct secure messaging: angella.john.2@33442.direct.athenahealth.com
  • Direct secure messaging: angella.john.1@14940.direct.athenahealth.com
  • Direct secure messaging: angella.john@mdpc-fl.direct.office.nextgen.com

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1962886705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FAIRWAY DR STE 305",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411802",
            "telephone_number": "954-744-0020",
            "fax_number": "754-318-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FAIRWAY DR STE 305",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411802",
            "telephone_number": "954-744-0020",
            "fax_number": "754-318-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "ANGELLA",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "APRN9212723",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "APRN9212723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN9212723",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.