Angela Renee Smith, MD

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

46413 Issued in MN

Practice address

420 Delaware St SE
MMC 293
Minneapolis, MN 55455-0341

Phone

(612) 625-7634

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Childrens Health Care

  • Pediatrics Physician
  • Minneapolis, MN
  • NPI 1932208808
  Medicare reassignment NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Winona Health Services

  • General Acute Care Hospital
  • Winona, MN
  • NPI 1295789352
  Medicare reassignment NPD
• Childrens Health Care

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1689778912
  NPD
• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043365984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 COTTAGE AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551174348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 293",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-625-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MN",
            "license": "46413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Emily Smith, OT
• Alycia Renae Smith, CMT
• Amanda J Smith, PA-C
• Amaya N Smith
• Andrew Charles Smith
• Anna M Smith, PAC
• Benjamin A Smith
• Blair Marie Smith
• Bobbi Jo Smith, RN
• Brenda Mae Smith, LPN

• Pediatric Hematology & Oncology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Hematology & Oncology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.