Quinta Awah-Ndang Mbongho

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P62494 Issued in IA

Practice address

3600 30TH St
Des Moines, IA 50310-5753

Phone

(515) 699-5999

NPI assigned

Sep 7, 2024

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 names 1

• Quinta Enow Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bethel Health Services LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Ankeny, IA
  • NPI 1225738149
  NPD

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

{
    "created_epoch": "1725667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725667200000",
    "number": "1003641093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 SE GRANT ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500219472",
            "telephone_number": "908-377-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 30TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105753",
            "telephone_number": "515-699-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBONGHO",
        "first_name": "QUINTA",
        "middle_name": "AWAH-NDANG",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-07",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P62494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "QUINTA",
            "last_name": "ENOW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Maxwell, ARNP
• Jamie May
• Jordan Teryn May, D.D.S
• Pooja Mayur, DO
• Erica Lynn Mazza-Morgan, RRT
• Willie Carl MC Clairen Jr., MD
• Elisa McAfee
• David W. McAllister, D.O.
• Brandy Kay McArtor, PHARMD
• Thomas McAuliff, DO

• Licensed Practical Nurse in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Licensed Practical Nurse in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.