Active NPI
Maimouna Kalmogo
- Case Manager/Care Coordinator
- Washington, DC
National Provider Identifier
1063775120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 2811 Pennsylvania Ave SE
Washington, DC 20020-3865 - Phone
- (202) 894-6811
- NPI assigned
- Jun 22, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary | ||
| Community Health Worker | 172V00000X | 2281846832009 | DC |
Addresses
Primary practice location
2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Mailing address
715 Ottis Place NW
Washington, DC 20010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2281846832009 | DC | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690156800000",
"number": "1063775120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 OTTIS PLACE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2811 PENNSYLVANIA AVE SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200203865",
"telephone_number": "202-894-6811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALMOGO",
"first_name": "MAIMOUNA",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-22",
"last_updated": "2023-07-24",
"certification_date": "2023-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "DC",
"license": "2281846832009",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.