Angela Michelle Theobald

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

53-77752 Issued in KS

Practice address

1919 N Amidon Ave Ste 100
Wichita, KS 67203-2118

Phone

(316) 866-2000

NPI assigned

Jul 12, 2017

Last updated

Feb 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Soma Psychiatry LLCGroup PAC ID 2961937719, 4 clinicians

Soma Recovery LLCGroup PAC ID 7810387339, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Soma Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Wichita, KS
  • NPI 1255166039
  Medicare reassignment Care Compare group NPD
• Soma Recovery LLC

  • Mental Health Counselor
  • Wichita, KS
  • NPI 1750850723
  Medicare reassignment Care Compare group NPD
• Eras Mental Health RX LLC

  • Clinic/Center
  • Wichita, KS
  • NPI 1134071574
  NPD Authorized official
• Gracemed Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1184691693
  Medicare reassignment

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1427570373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 N TOPEKA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142810",
            "telephone_number": "316-866-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 N AMIDON AVE STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672032118",
            "telephone_number": "316-866-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOBALD",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "77752",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Young Men's Christian Association of Wichita, Kansas (Greater Wichita YMCA)
• Javanthi Theegala, MD
• Esther Jean Theis
• Paula K Theisen, OTR
• Thenudge LLC (The Nudge)
• Theracare, LLC
• Therapeutic Massage Group and Equipment
• Therapeutic Medical Supply Inc
• Therapeutic Paradigm
• Therapeutic Time, LLC

• Family Nurse Practitioner in Wichita, KS
• Providers in Wichita, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.