Active NPI
Kadie Nkemanteh
- Registered Nurse
- Upper Marlboro, MD
National Provider Identifier
1275018277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN1047414
- Practice address
- 3014 Winterbourne Dr
Upper Marlboro, MD 20774-9105 - Phone
- (202) 570-8755
- NPI assigned
- Sep 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN1047414 | DC | Primary |
Addresses
Primary practice location
3014 Winterbourne Dr
Upper Marlboro, MD 20774-9105
Mailing address
3014 Winterbourne Dr
Upper Marlboro, MD 20774-9105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN1047414 | DC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Provision Care LLC | Current | 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.
-
- Home Health Agency
- Herndon, VA
- NPI 1780531293
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537920000000",
"number": "1275018277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3014 WINTERBOURNE DR",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207749105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3014 WINTERBOURNE DR",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207749105",
"telephone_number": "202-570-8755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NKEMANTEH",
"first_name": "KADIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-26",
"last_updated": "2018-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "DC",
"license": "RN1047414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upper Marlboro, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.