Active NPI
Angela Kasbohm, L.D.
- Registered Dietitian
- El Reno, OK
National Provider Identifier
1861572505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1068
- Practice address
- 2115 Parkview Dr
El Reno, OK 73036-2109 - Phone
- (405) 262-2640
- Fax
- (405) 422-2521
- NPI assigned
- Oct 17, 2006
- Last updated
- Oct 27, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1068 | OK | Primary |
Addresses
Primary practice location
2115 Parkview Dr
El Reno, OK 73036-2109
Mailing address
2115 Parkview Dr
El Reno, OK 73036-2109
Phone (405) 262-2640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1068 | Other | OK | LD LICENSE |
Other names 1
- Angela Hoffman
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1068 | OK | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319673600000",
"number": "1861572505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 PARKVIEW DR",
"city": "EL RENO",
"state": "OK",
"postal_code": "730362109",
"telephone_number": "405-262-2640",
"fax_number": "405-422-2521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 PARKVIEW DR",
"city": "EL RENO",
"state": "OK",
"postal_code": "730362109",
"telephone_number": "405-262-2640",
"fax_number": "405-422-2521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASBOHM",
"first_name": "ANGELA",
"credential": "L.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2011-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1068",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LD LICENSE",
"identifier": "1068",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANGELA",
"last_name": "HOFFMAN",
"credential": "L.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in El Reno, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.