Individual provider Active NPI

Ndematelen Asong, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Worthington, OH
National Provider Identifier
1265616999
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0030865 Issued in OH
Practice address
507 Alta View Village CT
Worthington, OH 43085-5900
Phone
(614) 515-7698
NPI assigned
Dec 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.331699 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0030865 OH Primary

Addresses

Primary practice location

507 Alta View Village CT
Worthington, OH 43085-5900

Mailing address

507 Alta View Village CT
Worthington, OH 43085-5900
Phone (614) 515-7698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.331699OHMDRegistered Nurse
APRN.CNP.0030865OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanguine Health Solutions, LLC PastSince Apr 10, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1265616999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 ALTA VIEW VILLAGE CT",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430855900",
            "telephone_number": "614-515-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 ALTA VIEW VILLAGE CT",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430855900",
            "telephone_number": "614-515-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASONG",
        "first_name": "NDEMATELEN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.331699",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0030865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

Verify at the official NPI Registry.