Organization Active NPI

J Healthcare Services and Consultation

  • Family Nurse Practitioner
  • Bowie, MD
National Provider Identifier
1104255744
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN1011679 Issued in DC
Legal business name
J HEALTHCARE SERVICES AND CONSULTATION
Practice address
4234 Lavender LN
Bowie, MD 20720-4291
Phone
(301) 717-2972
NPI assigned
Nov 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Authorized official

Name
Mr. Joseph E Kisanga, NPNPI 1831473628
Title
Chairman
Phone
(301) 717-2972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X RN1011679 DC Primary

Addresses

Primary practice location

4234 Lavender LN
Bowie, MD 20720-4291

Mailing address

4234 Lavender LN
Bowie, MD 20720-4291
Phone (301) 717-2972

Other identifiers 1

IdentifierTypeStateIssuer
1104255744OtherMDNPI FOR J HEALTHCARE SERVICES AND CONSULTATION

Other names 1

  • Wound team of greater Washington Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140326001724 DC Part B Supplier - Clinic/Group Practice 8729219225 Receives reassigned benefits from 1 practitioner
Practice locations: Bowie, MD; Washington, DC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1104255744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 LAVENDER LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204291",
            "telephone_number": "301-717-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 LAVENDER LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204291",
            "telephone_number": "301-717-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J HEALTHCARE SERVICES AND CONSULTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "KISANGA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "301-717-2972",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1011679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR J HEALTHCARE SERVICES AND CONSULTATION",
            "identifier": "1104255744",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wound team of greater Washington",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.