Kulling Nji Abi

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Kent, OH

NPI 1104237684 · NPPES record last updated Dec 15, 2021

Key facts

NPI
1104237684
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
APRN.CNP.0029881 (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
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

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., Inc (22 clinicians)

Practice addresses (Care Compare)

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220214001851 OH Practitioner - Nurse Practitioner 2860885969 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PN134199M-IVOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Chariot Homehealth Care & Staffing Agency Current Accepting new patients
Rakesh Ranjan MD & Associates, Inc. Current
since Jan 27, 2022
Accepting new patients
Rakesh Ranjan M.D. & Assoc., Inc. Psychiatric/Mental Health Current
since 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) 504-3646

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

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

Specialties & licenses

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

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

Other providers in Kent, OH

All providers in Kent, OH · Psychiatric/Mental Health Nurse Practitioner in Ohio

Sources for this page

Verify at the official NPI Registry.