Puria Atemnkeng Kenne, PHARM.D.

Primary specialty

DriverTaxonomy code 172A00000X

License

K500696018234 Issued in MD

Practice address

5621 Sargent Rd
Chillum, MD 20782-2335

Phone

(301) 559-3333

NPI assigned

Nov 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1295079762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5621 SARGENT RD",
            "city": "CHILLUM",
            "state": "MD",
            "postal_code": "207822335",
            "telephone_number": "301-559-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5621 SARGENT RD",
            "city": "CHILLUM",
            "state": "MD",
            "postal_code": "207822335",
            "telephone_number": "301-559-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNE",
        "first_name": "PURIA",
        "middle_name": "ATEMNKENG",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "26520",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MD",
            "license": "K500696018234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "chillum",
            "affiliation": "N",
            "address_1": "5621 Sargent Rd",
            "city": "Chillum",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207822335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Holly Brown
• Lindsey Campbell, LCSW-C
• Latajha A. Coker, LMSW
• Laura Goudreau
• Demetrius Keller
• Patricia Hope Lieberman, LMSW
• Jennifer Maclaughlin
• Delphine Abong Mbah
• Keilettia Michelle McCaskill, M.S.,CCC-SLP
• Asaah Anyama Mofor Ingrid

• All providers in Chillum, MD
• Driver in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.