Individual provider Active NPI

Kilole A Kanno, DO

  • Emergency Medicine Physician
  • Takoma Park, MD
National Provider Identifier
1114188372
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102202205 Issued in VA
Practice address
7600 Carroll Avenue
Washington Adventist Hospital
Takoma Park, MD 20912
Phone
(301) 891-5070
Fax
(301) 891-5132
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0102202205 VA Primary

Addresses

Primary practice location

7600 Carroll Avenue
Washington Adventist Hospital
Takoma Park, MD 20912

Mailing address

20010 Century Blvd Suite 200
Emergency Medicine Associates
Germantown, MD 20874
Phone (240) 686-2300

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080813000697 DC Practitioner - Emergency Medicine 8628143450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

655 Watkins Mill Rd
Gaithersburg, MD 20879-3301
Phone (240) 632-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102202205VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Jul 1, 2008 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 4, 2015 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 1, 2008 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 4, 2015 Accepting new patients

Locations

20010 Century Blvd
Ste 200
Germantown, MD 20874

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

7600 Carroll Ave
Takoma Park, MD 20912
Phone (301) 791-7600

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

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.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1114188372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20010 CENTURY BLVD SUITE 200",
            "address_2": "EMERGENCY MEDICINE ASSOCIATES",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "20874",
            "telephone_number": "240-686-2300",
            "fax_number": "240-686-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 CARROLL AVENUE",
            "address_2": "WASHINGTON ADVENTIST HOSPITAL",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "20912",
            "telephone_number": "301-891-5070",
            "fax_number": "301-891-5132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNO",
        "first_name": "KILOLE",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102202205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

Verify at the official NPI Registry.