Individual provider Active NPI

Anita K Kombo, FNP-C

  • Family Nurse Practitioner
  • Bear, DE
National Provider Identifier
1144921909
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0012258 Issued in DE
Practice address
1545 Pulaski Hwy
Bear, DE 19701-1303
Phone
(302) 832-8701
NPI assigned
Mar 16, 2023
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LG-0012258 DE
Family Nurse Practitioner 363LF0000X LG-0012258 DE Primary

Addresses

Primary practice location

1545 Pulaski Hwy
Bear, DE 19701-1303

Mailing address

1545 Pulaski Hwy
Bear, DE 19701-1303
Phone (302) 832-8701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230801000058 DE Practitioner - Nurse Practitioner 9931560430 Reassigns benefits to 1 organization
I20230801000097 MD Practitioner - Nurse Practitioner 9931560430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Quality PartnersGroup PAC ID 0143657247, 96 clinicians

Practice addresses (Care Compare)

200 Hygeia Dr
Newark, DE 19713-2049
Phone (302) 273-1701

310 E Pulaski Hwy
Christianacare Gohealth Urge
Elkton, MD 21921-6435
Phone (443) 485-6213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Quality Partners CurrentSince Jul 1, 2023 Accepting new patients
Christiana Care Quality Partners PastSince Aug 1, 2021 Accepting new patients

Locations

200 Hygeia Dr
Newark, DE 19713
Phone (302) 273-1701

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4724 Limestone Rd
Wilmington, DE 19808
Phone (302) 467-3595

310 E Pulaski Hwy
Elkton, MD 21921
Phone (443) 485-6213

101 North East Plz
North East, MD 21901
Phone (410) 543-2020

Interoperability endpoints

  • Direct secure messaging: anita.kombo@ghuccc.eclinicaldirectplus.com

Organizations & group practices 2

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": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1144921909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 PULASKI HWY",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197011303",
            "telephone_number": "302-832-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 PULASKI HWY",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197011303",
            "telephone_number": "302-832-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMBO",
        "first_name": "ANITA",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0012258",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bear, DE

Sources for this page

Verify at the official NPI Registry.