Angeline Kathleen Williams, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R175676 Issued in MD

Practice address

910 Frederick Rd
Catonsville, MD 21228-4516

Phone

(410) 644-1880

Fax

(410) 646-3623

NPI assigned

Jun 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Angeline Kathleen Jackson Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187
  Medicare reassignment Care Compare group NPD
• Center for Pain Management, LLC

  • Interventional Pain Medicine Physician
  • Hagerstown, MD
  • NPI 1962463265
  Medicare reassignment NPD
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Olney, MD
  • NPI 1487093167
  Medicare reassignment NPD
• St. Paul Place Specialists, Inc.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Baltimore, MD
  • NPI 1871549196
  Medicare reassignment NPD
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Leonardtown, MD
  • NPI 1578902375
  NPD
• St Paul Place Specialists Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1497707681
  NPD
• St. Paul Place Specialists, Inc.

  • Orthopaedic Surgery Physician
  • Baltimore, MD
  • NPI 1831471234
  NPD
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Gainesville, VA
  • NPI 1063393833
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Medstar Good Samaritan Physicians LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1679996078
  NPD (past)
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD (past)

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1992365902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 FREDERICK RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284516",
            "telephone_number": "410-644-1880",
            "fax_number": "410-646-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 FREDERICK RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284516",
            "telephone_number": "410-644-1880",
            "fax_number": "410-646-3623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANGELINE",
        "middle_name": "KATHLEEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R175676",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R175676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELINE",
            "last_name": "JACKSON",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natacha Y Wheeler, CRNP-PMH
• Whole Nutrition Services
• Lindsey Wilhelm, CF-SLP
• Shannon William
• Paulette Williams-Tillery, PHD
• Charlene Williams, LCSW-C
• David C Williams, DDS
• Elizabeth Shaw Williams, LCSW-C
• Gloria Williams
• Jayme Brooke Williams, P.A.-C

• Gerontology Nurse Practitioner in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Gerontology Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.