Individual provider Active NPI

Angela Elaine Smedo, DO

  • Psychiatry Physician
  • Novi, MI
National Provider Identifier
1598250698
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5101024364 Issued in MI
Practice address
28175 Haggerty Rd Ste 146
Novi, MI 48377-2903
Phone
(248) 994-9006
NPI assigned
Jun 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101024364 MI Primary

Addresses

Primary practice location

28175 Haggerty Rd Ste 146
Novi, MI 48377-2903

Mailing address

28175 Haggerty Rd Ste 146
Novi, MI 48377-2903
Phone (248) 994-9006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220712001001 MI Practitioner - Psychiatry 1355721093 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101024364MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC CurrentSince Jul 1, 2022 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Jul 1, 2022 Accepting new patients

Locations

1760 S Telegraph Rd
Ste 200
Bloomfield Township, MI 48302

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

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": "1530316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1598250698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28175 HAGGERTY RD STE 146",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772903",
            "telephone_number": "248-994-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28175 HAGGERTY RD STE 146",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772903",
            "telephone_number": "248-994-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMEDO",
        "first_name": "ANGELA",
        "middle_name": "ELAINE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-30",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101024364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.