Individual provider Active NPI

Angela Wright, FNP-C

  • Nurse Practitioner
  • Benton Harbor, MI
National Provider Identifier
1972053825
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704184227 Issued in MI
Practice address
800 M 139
Benton Harbor, MI 49022-3881
Phone
(269) 927-5400
Fax
(269) 927-4208
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704184227 MI Primary

Addresses

Primary practice location

800 M 139
Benton Harbor, MI 49022-3881

Mailing address

50 Industrial Park Rd
Bangor, MI 49013-1246
Phone (269) 427-7937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20161101002713 MI Practitioner - Nurse Practitioner 3971881517 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704184227MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intercare Community Health Network CurrentSince Oct 3, 2016 Accepting new patients
Intercare Community Health Network CurrentSince Oct 3, 2016 Accepting new patients

Locations

308 Charles St
Bangor, MI 49013
Phone (269) 427-7967

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

870 Colfax Ave
Benton Harbor, MI 49022
Phone (269) 605-1277

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

7450 Hochberger Rd
Eau Claire, MI 49111
Phone (855) 869-6900

285 James St
Holland, MI 49424
Phone (616) 399-0200

538 Washington St
Otsego, MI 49078
Phone (269) 694-7873

5498 109th Ave
Pullman, MI 49450
Phone (269) 236-5021

Interoperability endpoints

  • Direct secure messaging: angela.wright@ichn.eclinicaldirectplus.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": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1972053825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 INDUSTRIAL PARK RD",
            "city": "BANGOR",
            "state": "MI",
            "postal_code": "490131246",
            "telephone_number": "269-427-7937",
            "fax_number": "269-427-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490223881",
            "telephone_number": "269-927-5400",
            "fax_number": "269-927-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "ANGELA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704184227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

Verify at the official NPI Registry.