Active NPI
Angela Douglas
- Medical-Surgical Registered Nurse
- Brooklyn, NY
National Provider Identifier
1982116166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- 436104-1
- Practice address
- 1001 E 55TH St
Brooklyn, NY 11234-1701 - Phone
- (347) 517-2452
- NPI assigned
- Oct 28, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 436104-1 | NY | |
| Medical-Surgical Registered Nurse | 163WM0705X | 436104-1 | NY | Primary |
Addresses
Primary practice location
1001 E 55TH St
Brooklyn, NY 11234-1701
Mailing address
1001 E 55TH St
Brooklyn, NY 11234-1701
Phone (347) 517-2452
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 436104-1 | Other | NY | RN LICENSURE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 436104-1 | NY | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509148800000",
"number": "1982116166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 E 55TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112341701",
"telephone_number": "347-517-2452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 E 55TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112341701",
"telephone_number": "347-517-2452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "ANGELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-28",
"last_updated": "2017-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "163WA0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "436104-1",
"primary": false
},
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "NY",
"license": "436104-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSURE",
"identifier": "436104-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.