Individual provider Active NPI

Renee Marie Al-Darraji, NP

  • Family Nurse Practitioner
  • Kittery, ME
National Provider Identifier
1194542837
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP241527 Issued in ME
Practice address
35 Walker St
Kittery, ME 03904-1727
Phone
(207) 439-4430
NPI assigned
Sep 24, 2024
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP241527 ME Primary

Addresses

Primary practice location

35 Walker St
Kittery, ME 03904-1727

Mailing address

35 Walker St
Kittery, ME 03904-1727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241206001292 ME Practitioner - Nurse Practitioner 0143756601 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP241527MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Pathology Inc Current Accepting new patients
York Hospital CurrentSince Nov 4, 2024 Accepting new patients
York Hospital PastSince Sep 29, 2024 Accepting new patients

Locations

35 Walker St
Kittery, ME 03904
Phone (207) 439-4430

15 Hospital Dr
York, ME 03909
Phone (207) 351-2478

Organizations & group practices 3

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": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1194542837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 WALKER ST",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 WALKER ST",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039041727",
            "telephone_number": "207-439-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-DARRAJI",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP241527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittery, ME

Sources for this page

Verify at the official NPI Registry.