Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Angela South

Individual provider Registered Nurse · NPI 1114629540

Angela South is a Nurse Practitioner in Medina, Ohio. Qualified in 2023, 3 years ago. Practices with Alcove Ventures LLC, a 50-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
3
Licensed in
OH
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

3567 Reserve Commons Dr Ste 100
Medina, OH 44256-5344
Phone: (330) 664-9250
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 0034233 (OH)
Registered Nurse Taxonomy 163W00000X · Licence 398808 (OH)

Record details

NPI number1114629540
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 20, 2023
Last updated in NPPESJune 26, 2023
Certification dateJune 26, 2023
Mailing address3567 Reserve Commons Dr Ste 100, Medina, OH 44256-5344

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Alcove Ventures Llc — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Medina