Angela M Prendergast, STNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

501064030106 Issued in OH

Practice address

14870 Georgetown St NE
Minerva, OH 44657-9134

Phone

(330) 862-3000

NPI assigned

May 4, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mrs. Angela Bagshaw Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1902018633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14870 GEORGETOWN ST NE",
            "city": "MINERVA",
            "state": "OH",
            "postal_code": "446579134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14870 GEORGETOWN ST NE",
            "city": "MINERVA",
            "state": "OH",
            "postal_code": "446579134",
            "telephone_number": "330-862-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "ANGELA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "STNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "501064030106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STNA REGISTRATION NUMBER",
            "identifier": "501064030106",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2717500",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "BAGSHAW",
            "prefix": "MRS.",
            "credential": "STNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melissa Anne Overly, RPH
• Perry M Lieberman OD
• Kelly Plottner, COTA/L
• Amanda Preas
• Premier Health Associates Inc
• Debora Jean Prendergast, PTA
• Michael Pribula, DO
• Quest Recovery and Prevention Services, Inc.
• Rath Optometry LLC
• Ted A Rath, OD

• All providers in Minerva, OH
• Nurse's Aide in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.