Angela Wozniak Minor, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PYR0476 Issued in MO

Practice address

600 SW Jefferson Street
Ste 206
Lees Summit, MO 64063

Phone

(816) 554-7705

Fax

(816) 554-7706

NPI assigned

Mar 13, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Kansas School of Med (KC/Wich/Sal), 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Douglas B Vaughan PHD PC

  • Clinical Psychologist
  • Lees Summit, MO
  • NPI 1881894145
  NPD (past)
• Clinical Associates PA

  • Specialist
  • Lenexa, KS
  • NPI 1477588085
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801929658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 SW ROBERTS COURT",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "64082",
            "telephone_number": "816-554-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SW JEFFERSON STREET",
            "address_2": "STE 206",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "64063",
            "telephone_number": "816-554-7705",
            "fax_number": "816-554-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "ANGELA",
        "middle_name": "WOZNIAK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "PYR0476",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "0963",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "24579038",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steve D Miller, DC
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• Kevin Ray Minnick, DPT
• Tammy Rayann Minshall, FNP-C
• Mint Dental Summit LLC
• Mohammed Azher Mirza, MD
• Robin Sophia Mishler, CCC-SLP
• Missouri CVS Pharmacy LLC

• Clinical Psychologist in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.