Angela M. Smith, DNP, PMHNP-BC, CMGT

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

RN236161 Issued in OH

Practice address

9250 W Thomas Rd
Phoenix, AZ 85037-3382

Phone

(602) 815-5964

NPI assigned

Aug 26, 2008

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

Other names 1

• Ms. Angela M. Klupp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1114174737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20304 W WHITE TANKS MTN RD STE A",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853559895",
            "telephone_number": "419-566-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373382",
            "telephone_number": "602-815-5964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1456 Park Ave W",
            "address_2": "Suite N",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449062700",
            "country_code": "US",
            "telephone_number": "419-529-4602 x1306",
            "fax_number": "419-529-4664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANGELA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC, CMGT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OH",
            "license": "RN236161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "KLUPP",
            "middle_name": "M.",
            "prefix": "MS.",
            "credential": "MSN/ED, CDCES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Grace Dufour Smith, LM, CPM
• Andrea Smith
• Andrew Smith
• Andrew P Smith, M.D.
• Angela Smith
• Anthony A Smith, M.D.
• Arvin Maxwell Smith, MD
• Ashleigh Smith, RBT
• Audrey Lee Smith, PSY.D.
• Bethany Smith, LPC

• Diabetes Educator Registered Nurse in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Diabetes Educator Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.