Individual provider Active NPI

Rahimatou N/a Nkwanui

  • Health Service Psychologist
  • Upper Marlboro, MD
National Provider Identifier
1083273635
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
HHA13641 Issued in DC
Practice address
16 Bannington Dr Uppr Marlboro
Upper Marlboro, MD 20774-1438
Phone
(202) 660-8851
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X HHA13641 DC Primary

Addresses

Primary practice location

16 Bannington Dr Uppr Marlboro
Upper Marlboro, MD 20774-1438

Mailing address

16 Bannington Dr Uppr Marlboro
Upper Marlboro, MD 20774-1438
Phone (202) 660-8851

Other identifiers 1

IdentifierTypeStateIssuer
N-250-73000896MedicaidMD

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

LicenseStateTypeSpecialty
HHA13641DCMDHealth Service Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1083273635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BANNINGTON DR UPPR MARLBORO",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741438",
            "telephone_number": "202-660-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BANNINGTON DR UPPR MARLBORO",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741438",
            "telephone_number": "202-660-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKWANUI",
        "first_name": "RAHIMATOU",
        "middle_name": "N/A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "DC",
            "license": "HHA13641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N-250-73000896",
            "state": "MD"
        }
    ],
    "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 Jun 7, 2019; 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.