Individual provider Active NPI

Atem Nkengbeza Eugine-Nkengbeza

  • Case Manager/Care Coordinator
  • Upper Marlboro, MD
National Provider Identifier
1073299178
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
9100 Fairhaven Ave
Upper Marlboro, MD 20772-5308
Phone
(240) 708-3988
NPI assigned
Jun 23, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

9100 Fairhaven Ave
Upper Marlboro, MD 20772-5308

Mailing address

9100 Fairhaven Ave
Upper Marlboro, MD 20772-5308
Phone (240) 708-3988

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

NPI Registry JSON

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1073299178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 FAIRHAVEN AVE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207725308",
            "telephone_number": "240-708-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 FAIRHAVEN AVE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207725308",
            "telephone_number": "240-708-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUGINE-NKENGBEZA",
        "first_name": "ATEM",
        "middle_name": "NKENGBEZA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.

Verify at the official NPI Registry.