ANGELA MARIE PETTUS (DNP) – Nurse Practitioner, NPI 1336873371
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,023 NURSE PRACTITIONER in MO
Provider Addresses for ANGELA MARIE PETTUS (DNP)
1000 Carondelet Dr # 201B
Kansas City, MO 641144673
Phone: (913) 956-2551
Type: Location
12310 W 54TH ST
SHAWNEE, KS 662161402
Phone: (913) 284-1889
Type: Location
4125 STATE LINE RD
KANSAS CITY, MO 641114423
Phone: (913) 284-1889
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 72 Open Payments records for all available years, with a total value of $1,411.
Total Amount is formed as General ($1,411) + Research ($0) + Ownership ($0) = $1,411.
Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($215).
Total Amount
$1,411
General + Research + Ownership
Payments
72
Total payment records
General Amount
$1,411
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-22
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220803002237 | I | Nurse Practitioner | MO | TBD |
| I20251121002088 | I | Nurse Practitioner | KS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 64114)
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