Individual provider Active NPI

Angela Nicole Oshkaloff

  • Intellectual & Developmental Disabilities Psychologist
  • Holly, MI
National Provider Identifier
1114365277
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Practice address
6594 Perryville Rd
Holly, MI 48442-9499
Phone
(586) 212-5677
NPI assigned
Jun 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X Primary

Addresses

Primary practice location

6594 Perryville Rd
Holly, MI 48442-9499

Mailing address

6594 Perryville Rd
Holly, MI 48442-9499
Phone (586) 212-5677

Other practice location 1

45589 Utica Grn W
Shelby Twp, MI 48317-5167
Phone (586) 212-5677

Other names 1

  • Angela N Pryor Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1114365277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6594 PERRYVILLE RD",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484429499",
            "telephone_number": "586-212-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6594 PERRYVILLE RD",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484429499",
            "telephone_number": "586-212-5677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45589 Utica Grn W",
            "address_purpose": "LOCATION",
            "city": "Shelby Twp",
            "state": "MI",
            "postal_code": "483175167",
            "country_code": "US",
            "telephone_number": "586-212-5677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSHKALOFF",
        "first_name": "ANGELA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "PRYOR",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holly, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.