JOSEPH MICHAEL ANGELO (NPI# 1992831895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992831895 |
Entity Type | Individual |
Full Name | JOSEPH MICHAEL ANGELO |
Credential | PA |
Practice Address |
1500 Line Avenue Ste 100 Shreveport LA 71101 |
Mailing Address |
1500 Line Avenue Ste 204 Shreveport LA 71101 |
Practice Telephone | 3186353052 |
Practice Fax Number | 3186326087 |
Mailing Telephone | 3186295001 |
Mailing Fax Number | 3186295020 |
Enumeration Date | 2007-02-26 |
Last Update Date | 2008-01-02 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10405 | LA | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA.A10405 | LA | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669736542 | Joseph Ted Angelo | Pharmacist | 13898 Ne 28th St, Vancouver, WA 98682-8844 | 2012-06-26 |
1760790927 | Joseph R Angelo II | Pediatrics | 6410 Fannin St, 500, Houston, TX 77030-3000 | 2010-09-21 |
1114075900 | Joseph E. Angelo | Internal Medicine | 9400 Rosecrans Ave, Bellflower, CA 90706-2246 | 2007-01-08 |
1740351147 | Joseph Angelo | Internal Medicine | 208 Plumtree Rd, Suite D, Bel Air, MD 21015-6056 | 2006-11-10 |
Street Address |
1500 LINE AVENUE STE 100 |
City | SHREVEPORT |
State | LA |
Zip Code | 71101 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295739001 | William L Overdyke | Orthopaedic Surgery | 1500 Line Avenue, Suite 100, Shreveport, LA 71101 | 2005-06-09 |
1790196657 | Specialists Hospital Shreveport | Pharmacy | 1500 Line Avenue, Suite 206, Shreveport, LA 71101 | 2014-05-14 |
1417189465 | Clay Eric Morgan | Physician Assistant | 1500 Line Avenue, Ste 100, Shreveport, LA 71101-4639 | 2009-08-10 |
1659503613 | Trey M Harold | Physician Assistant | 1500 Line Avenue, Suite 100, Shreveport, LA 71101-4639 | 2009-08-10 |
1104057694 | Specialists Hospital Shreveport, LLC | Prosthetic/Orthotic Supplier | 1500 Line Avenue, Suite 206, Shreveport, LA 71101-4639 | 2009-07-31 |
1598891491 | Stephen Michael Brandao Jr. | Nurse Practitioner | 1500 Line Avenue, Ste 200, Shreveport, LA 71101 | 2007-02-26 |
1891821583 | Chris D Howard | Nurse Practitioner | 1500 Line Avenue, Ste 200, Shreveport, LA 71101 | 2007-02-26 |
1255470118 | John David Googe | Orthopaedic Surgery | 1500 Line Avenue, Ste 100, Shreveport, LA 71101 | 2007-02-06 |
1346393816 | Michele Allison | Occupational Therapist | 1500 Line Avenue, Ste 100, Shreveport, LA 71101 | 2007-01-19 |
1073585477 | Philip Andrew Utter | Neurological Surgery | 1500 Line Avenue, Ste 200, Shreveport, LA 71101 | 2006-02-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
Find all providers in zip 71101 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790228013 | Brian Keith Fontenot | Physician Assistant | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2016-11-18 |
1831412626 | Christopher Micheal Magill | Physician Assistant | 2551 Greenwood Rd Ste 210, Shreveport, LA 71103-3985 | 2010-03-08 |
1851401426 | Teresa Bigler | Physician Assistant | 1606 Kings Hwy, Shreveport, LA 71103-4128 | 2006-08-30 |
1730118365 | Tina Faith Gentry | Physician Assistant | 7925 Youree Dr Suite 280b, Shreveport, LA 71105-5538 | 2006-07-03 |
1487616538 | David Stanley Staton | Physician Assistant | Overton Brooks Vamc, 510 East Stoner Ave, Shreveport, LA 71101 | 2006-04-04 |
1114924404 | Mary Mcferren | Physician Assistant | 1455 E Bert Kouns Industrial Loop # 200, Shreveport, LA 71105 | 2005-07-01 |
1487252029 | Melissa Raney | Physician Assistant | 2709 Mackey Ln, Shreveport, LA 71118-2556 | 2020-10-15 |
1629683230 | Amanda Renae Simmons | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
1700496312 | Caroline Leigh Harris | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-07 |
1811459449 | Lyndsey Pate Day | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2019-04-02 |
Find all providers in SHREVEPORT |
City | SHREVEPORT |
Zip Code | 71101 |
Please comment or provide details below to improve the information on JOSEPH MICHAEL ANGELO.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.