Khadijatu Koroma, NURSE PRACTIONER

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F05210435 Issued in MD

Practice address

14446 Layhill Rd
Silver Spring, MD 20906-1911

Phone

(301) 598-0725

Fax

(301) 598-0729

NPI assigned

Jun 2, 2021

Last updated

Mar 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Premier Choice Primary & Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Silver Spring, MD
  • NPI 1407597552

  DC, Primary Care

  Medicare reassignment NPD
• Hicare Home Health Care LLC

  • Home Health Agency
  • Clinton, MD
  • NPI 1225604069
  NPD Authorized official

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1023684867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 E CLINTON ST",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352106",
            "telephone_number": "301-254-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14446 LAYHILL RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061911",
            "telephone_number": "301-598-0725",
            "fax_number": "301-598-0729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7012 E Clinton St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MD",
            "postal_code": "207352106",
            "country_code": "US",
            "telephone_number": "301-254-1169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOROMA",
        "first_name": "KHADIJATU",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "F05210435",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R181191",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aminata Koroma
• Daniella Koroma
• Emma Koroma
• Finah Koroma
• Gladys Mrs Koroma, HHA
• Tidankay Koroma
• Victoria Fatmata Koroma
• Katalin Soltesz Korossy, M.D.
• Astrid Joselyne Korte
• Olena Korzh

• Primary Care Nurse Practitioner in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.