Individual provider Active NPI

Jessinta Ngunkeng, CNP

  • Family Nurse Practitioner
  • Lanham, MD
National Provider Identifier
1073916037
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R197237 Issued in MD
Practice address
9430 Annapolis Rd Ste D
Lanham, MD 20706-3030
Phone
(301) 377-4732
NPI assigned
Oct 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN1025199 DC
Family Nurse Practitioner 363LF0000X R197237 MD Primary

Addresses

Primary practice location

9430 Annapolis Rd Ste D
Lanham, MD 20706-3030

Mailing address

9430 Annapolis Rd
Lanham, MD 20706-3004

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211006003175 DC Practitioner - Nurse Practitioner 8426456302 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN1025199DCMDRegistered Nurse
R197237MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rapid Response Clinic LLC Family CurrentSince Aug 1, 2021 Accepting new patients
Medwell Beltsville Medical Clinic, Inc. PastSince Sep 1, 2020 Accepting new patients

Locations

9430 Annapolis Rd
Ste D
Lanham, MD 20706
Phone (301) 213-4664

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1073916037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 ANNAPOLIS RD",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 ANNAPOLIS RD STE D",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063030",
            "telephone_number": "301-377-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUNKENG",
        "first_name": "JESSINTA",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1025199",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R197237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.