Angela Marie Pettus, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

53-81365-091 Issued in KS

Practice address

8550 Marshall Dr Ste 200
Lenexa, KS 66214-9836

Phone

(913) 495-2000

Fax

(913) 495-3715

NPI assigned

Jul 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KC Diabetes and Endocrinology PAGroup PAC ID 4789915133, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• KC Diabetes & Endocrinology PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Overland Park, KS
  • NPI 1457907370
  Medicare reassignment Care Compare group NPD
• Prime Healthcare Kansas City - Physician Services LLC

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1427449487
  Medicare reassignment NPD
• Spine Pain and Rehab Associates LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Blue Springs, MO
  • NPI 1780157172
  Medicare reassignment NPD

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1336873371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 MARSHALL DR STE 200",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662149836",
            "telephone_number": "913-495-2000",
            "fax_number": "913-495-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 MARSHALL DR STE 200",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662149836",
            "telephone_number": "913-495-2000",
            "fax_number": "913-495-3715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Carondelet Dr # 201B",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144673",
            "country_code": "US",
            "telephone_number": "913-956-2551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4125 State Line Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641114423",
            "country_code": "US",
            "telephone_number": "913-284-1889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTUS",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KS",
            "license": "53-81365-091",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "53-81365-091",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-81365-091",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2022028087",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2022028087",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2022028087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward John Perkins Jr., D.D.S.
• Nyah Perkins
• Mary E Peterson, PT
• Terrie L Peterson
• Regan Danielle Pettijohn, PHARM.D.
• Thuy Pham
• Pharmacy Alternatives, LLC
• Pharmacy Corporation of America
• Pharmacy Corporation of America
• Pharmscript of KS LLC

• Nurse Practitioner in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.