Individual provider Active NPI

Angela Renee Means, CPSS, CADCR

  • Peer Specialist
  • Salisbury, NC
National Provider Identifier
1952120438
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
2022-5563-01 Issued in NC
Practice address
1217 Beachnut LN
Salisbury, NC 28146-6010
Phone
(980) 440-1211
NPI assigned
Oct 10, 2024
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 2022-5563-01 NC Primary

Addresses

Primary practice location

1217 Beachnut LN
Salisbury, NC 28146-6010

Mailing address

1217 Beachnut LN
Salisbury, NC 28146-6010
Phone (980) 440-1211

Other names 1

  • Marcus Kenyatta Berry Professional 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

State licenses

LicenseStateTypeSpecialty
2022-5563-01NCMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Wellness and Supportive Services LLC Peer Specialist CurrentSince Oct 13, 2024 Accepting new patients
Overcomers of the Carolinas LLC CurrentSince Apr 6, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1952120438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 BEACHNUT LN",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281466010",
            "telephone_number": "980-440-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 BEACHNUT LN",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281466010",
            "telephone_number": "980-440-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEANS",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "credential": "CPSS, CADCR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NC",
            "license": "2022-5563-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCUS",
            "last_name": "BERRY",
            "middle_name": "KENYATTA",
            "credential": "CPSS, CADCR, CHW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.