Koosha Adham

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AC002818 Issued in MD

Practice address

4467 Old Branch Ave Ste 201
Temple Hills, MD 20748-1854

Phone

(703) 380-3200

NPI assigned

Apr 16, 2020

Last updated

Apr 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Medstar Southern Maryland Physicians, LLC

  dba Women's Health Center of Waldorf

  • Obstetrics & Gynecology Physician
  • White Plains, MD
  • NPI 1366644197
  NPD (past)

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1255951547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4467 OLD BRANCH AVE STE 201",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207481854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4467 OLD BRANCH AVE STE 201",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207481854",
            "telephone_number": "703-380-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADHAM",
        "first_name": "KOOSHA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "AC002818",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "AC002818",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "AC002818",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "AC002818",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaa Pediatric N Adult Healthcare Services
• Abdulhosein N Adham (abdulhasein n adham m.d.)
• Pearstine Adgerson, DDS
• Olufunmilayo Rebecca Agunbiade, PHARMD
• Jennifer Ah-Kee
• AIDS Healthcare Foundation (Ahf)
• Apie Akerie Nkwie
• Clara Akinseye

• Adult Health Nurse Practitioner in Temple Hills, MD
• Providers in Temple Hills, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.