Individual provider Active NPI

Nkengfack Chateh-Nkengtego, M.D

  • Family Medicine Physician
  • JB Andrews, MD
National Provider Identifier
1174724082
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101259796 Issued in VA
Practice address
1060 W Perimeter Rd
JB Andrews, MD 20762-6602
Phone
(240) 612-3783
NPI assigned
May 29, 2007
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0084118 MD
Family Medicine Physician 207Q00000X 0101259796 VA Primary

Addresses

Primary practice location

1060 W Perimeter Rd
JB Andrews, MD 20762-6602

Mailing address

1060 W Perimeter Rd
JB Andrews, MD 20762-6602
Phone (240) 612-3783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20171128000273 MD Practitioner - Family Practice 4183981269 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0084118MDMDFamily Medicine Physician
0101259796VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 22, 2018 Accepting new patients
Lifebridge Community Physicians, Inc Family Medicine CurrentSince Oct 30, 2017 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Oct 30, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 22, 2018 Accepting new patients

Locations

2629 Riva Rd
Ste 112
Annapolis, MD 21401
Phone (410) 266-1000

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

2101 E Jefferson St
#4E
Rockville, MD 20852

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Organizations & group practices 6

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1174724082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "240-612-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "240-612-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATEH-NKENGTEGO",
        "first_name": "NKENGFACK",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0084118",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101259796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in JB Andrews, MD

Sources for this page

Verify at the official NPI Registry.