Angel Nicole Hannah, PSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

125 S Main Cross St
Louisa, KY 41230-1065

Phone

(606) 638-0938

NPI assigned

Feb 13, 2023

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

• Angel Nicole Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1255038972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "ANGEL",
        "middle_name": "NICOLE",
        "credential": "PSS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "JOHNSON",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Peer Specialist in Louisa, KY
• Providers in Louisa, KY by specialty
• Peer Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.