Kumba Bah

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

323911-31 Issued in WI

Practice address

2961 Yarmouth Greenway Dr
Fitchburg, WI 53711-5809

Phone

(608) 665-1472

NPI assigned

Sep 27, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1043981368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 W MAIN ST",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902040",
            "telephone_number": "608-395-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 YARMOUTH GREENWAY DR",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115809",
            "telephone_number": "608-665-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAH",
        "first_name": "KUMBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "323911-31",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1-8233968852",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Theranest.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2961 Yarmouth Greenway Dr",
            "city": "Fitchburg",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537115809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Awooncare Home Health LLC
• Jaclyn M Ayers, PA
• Fahad Aziz, M.D
• Jessica Bach, RN
• Badgerland Billing LLC
• Qinglu Bai, LPC-IT
• Hailey Lynn Baldwin, PTA
• Carol Ballweg, APNP
• Matthew Bange, MD
• Ariana Bankhead, RN

• Licensed Practical Nurse in Fitchburg, WI
• Providers in Fitchburg, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.