Individual provider Active NPI

Angela Adams, RPH

  • Pharmacist
  • Glen Rose, TX
National Provider Identifier
1528291614
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
34922 Issued in TX
Practice address
906 N.E. Big Bend Trail
Glen Rose, TX 76043
Phone
(254) 897-2711
Fax
(254) 897-3751
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1-14380 KS
Pharmacist 183500000X 34922 TX Primary

Addresses

Primary practice location

906 N.E. Big Bend Trail
Glen Rose, TX 76043

Mailing address

906 N.E. Big Bend Trail
Glen Rose, TX 76043
Phone (254) 897-2711

Other identifiers 2

IdentifierTypeStateIssuer
1-14380OtherKSKANAS STATE BOARD OF PHARMACY LICENSE
34922OtherTXSTATE BOARD OF PHARMACY LICENSE NUMBER

Other names 1

  • Ms. Angie Adams 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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
1-14380KSMDPharmacist
34922TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pecan Prescription Shop LLC Past Accepting new patients
First Lone Star Pharmacy Group LLC PastSince Sep 15, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1528291614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 N.E. BIG BEND TRAIL",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "76043",
            "telephone_number": "254-897-2711",
            "fax_number": "254-897-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N.E. BIG BEND TRAIL",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "76043",
            "telephone_number": "254-897-2711",
            "fax_number": "254-897-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "ANGELA",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-14380",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "34922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANAS STATE BOARD OF PHARMACY LICENSE",
            "identifier": "1-14380",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY LICENSE NUMBER",
            "identifier": "34922",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGIE",
            "last_name": "ADAMS",
            "prefix": "MS.",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glen Rose, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.