Individual provider Active NPI

Kulling Nji Abi

  • Psychiatric/Mental Health Nurse Practitioner
  • Kent, OH
National Provider Identifier
1104237684
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0029881 Issued in OH
Practice address
901 Simon LN Apt 103
Kent, OH 44240-1742
Phone
(330) 990-8071
NPI assigned
May 18, 2014
Reactivated
Dec 14, 2021
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN134199M-IV OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0029881 OH Primary

Addresses

Primary practice location

901 Simon LN Apt 103
Kent, OH 44240-1742

Mailing address

901 Simon LN Apt 103
Kent, OH 44240-1742
Phone (330) 990-8071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220214001851 OH Practitioner - Nurse Practitioner 2860885969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rakesh Ranjan M.D. and Assoc., IncGroup PAC ID 6507895067, 22 clinicians

Practice addresses (Care Compare)

801 E Washington St
Suite 150
Medina, OH 44256-3336
Phone 21658767273402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PN134199M-IVOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rakesh Ranjan M.D. & Assoc., Inc. Psychiatric/Mental Health CurrentSince Jan 27, 2022 Accepting new patients
Chariot Homehealth Care & Staffing Agency Current Accepting new patients
Rakesh Ranjan MD & Associates, Inc. CurrentSince Jan 27, 2022 Accepting new patients
Chariot Homes LLC Current Accepting new patients

Locations

12395 McCracken Rd
Ste H
Garfield Hts, OH 44125
Phone (216) 375-9897

801 E Washington St
Medina, OH 44256
Phone (330) 722-1069

801 E Washington St
Ste 150
Medina, OH 44256
Phone (330) 722-1069

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1400371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1104237684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SIMON LN APT 103",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442401742",
            "telephone_number": "330-990-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SIMON LN APT 103",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442401742",
            "telephone_number": "330-990-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABI",
        "first_name": "KULLING",
        "middle_name": "NJI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-18",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "deactivation_date": "2021-11-29",
        "reactivation_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN134199M-IV",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0029881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

Verify at the official NPI Registry.