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ANGELA MARIE PETTUS DNP
NPI 1336873371
Nurse Practitioner in Kansas City, MO

Active since July 14, 2022PECOS EnrolledAccepts Medicare Assignment
4125 STATE LINE RD, KANSAS CITY, MO 64111(913) 284-1889 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 18, 2025, Jun 3, 2023, Jul 14, 2022 (3 updates tracked since 2022).

About Angela Marie Pettus Dnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANGELA MARIE PETTUS DNP (NPI 1336873371) is an individual nurse practitioner in Kansas City, Missouri, licensed in Kansas (53-81365-091) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Kansas City, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1336873371
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameANGELA MARIE PETTUSCredential: DNP
Location Address4125 STATE LINE RDKansas City, MO 64111-4423
Mailing Address12310 W 54th StShawnee, KS 66216-1402
Phone(913) 284-1889
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 14, 2022
Last NPPES UpdateNovember 18, 20253 updates tracked since enumeration
NPPES CertifiedNovember 18, 2025
✔ NPI 1336873371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Licenses✔ Licensed in KS · 53-81365-091✔ Licensed in MO · 2022028087
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 2022028087 (MO), 53-81365-091 (KS)
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 53-81365-091 (KS), 2022028087 (MO)
4125 STATE LINE RD, Kansas City, MO 64111
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Secondary Practice Location 1

Location 11000 Carondelet Dr # 201BKansas City, MO 64114-4673 · Phone (913) 956-2551

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Angela Marie Pettus Dnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911389226
PECOS Enrollment IDI20251121002088
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64111 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $55.29 – $168.52
Typical copayment $21.45 (range $13.82 – $42.13)
Most-billed visit code 99203
Established Patient
$97.82 typical visit price
range $17.60 – $137.20
Typical copayment $24.45 (range $4.40 – $34.30)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angela Pettus's NPI number?

The NPI number for Angela Pettus is 1336873371. It was assigned to this individual provider in the NPPES registry on July 14, 2022.

Where is Angela Pettus located?

Angela Pettus practices at 4125 State Line Rd, Kansas City, MO 64111. The listed phone number is (913) 284-1889.

What is Angela Pettus's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Angela Pettus enrolled in Medicare?

Yes. Angela Pettus is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Angela Pettus was last updated on November 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.