K a N Healthcare

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

K A N HEALTHCARE

Practice address

5 Brighton LN
Gaithersburg, MD 20877-1815

Phone

(240) 463-9739

NPI assigned

Jul 27, 2022

Last updated

Jul 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Odette Ntam, NPNPI 1396376729

Title

Owner

Phone

(240) 463-9739

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Odette Ntam, NP

  • Nurse Practitioner
  • Washington, DC
  • NPI 1396376729
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1144956624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BRIGHTON LN",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BRIGHTON LN",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771815",
            "telephone_number": "240-463-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K A N HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "NTAM",
        "authorized_official_first_name": "ODETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-463-9739",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jun Tae Bae, DDS, LLC (Family Dentistry of Gaithersburg)
• Jun Y. Lee, D.D.S., P.C.
• Eui Gil Jung, L.AC
• Ji Young Jung
• Carol Kline Juran, PHD
• Aline Antoinette Kadji-Tedjeu, FNP
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc (Gaithersburg Medical Center Laboratory)
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc (Gaithersburg Medical Center DPP)
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc (Kaiser Permanente Gaithersburg Medical Center Ambulatory Surgery Ctr)
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

• Internal Medicine Physician in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.