Individual provider Active NPI

Kemunto Mokora

  • Family Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1295303386
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0027696 Issued in OH
Practice address
313 Jefferson Ave
Toledo, OH 43604-1004
Phone
(419) 720-7883
NPI assigned
Jun 15, 2021
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0027696 OH Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704393156APP22 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0027696 OH
Addiction Medicine (Preventive Medicine) Physician 2083A0300X 0027696 OH

Addresses

Primary practice location

313 Jefferson Ave
Toledo, OH 43604-1004

Mailing address

313 Jefferson Ave
Toledo, OH 43604-1004
Phone (419) 720-7883

Other practice location 1

220 W Congress St
Detroit, MI 48226-3289
Phone (419) 378-0947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20231025002520 OH Practitioner - Nurse Practitioner 6507212677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Toledo College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1415 Jefferson Ave
Toledo, OH 43604-5827
Phone (419) 214-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0027696OHMDFamily Nurse Practitioner
4704393156APP22MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Association of Toledo, Inc. Current Accepting new patients
Neighborhood Health Association of Toledo, Inc Current Accepting new patients
Neighborhood Health Association of Toledo, Inc. CurrentSince Jan 11, 2025 Accepting new patients
Neighborhood Health Association of Toledo, Inc. Current Accepting new patients
Neighborhood Health Association of Toledo, Inc. CurrentSince Jan 11, 2025 Accepting new patients
Neighborhood Health Association of Toledo, Inc. Past Accepting new patients
Neighborhood Health Association of Toledo, Inc. Past Accepting new patients
Neighborhood Health Association of Toledo Inc. Past Accepting new patients
Neighborhood Health Association of Toledo, Inc. Past Accepting new patients
Neighborhood Health Association of Toledo, Inc Past Accepting new patients

Locations

225 N Irwin Rd
Holland, OH 43528
Phone (419) 214-4354

1 Unique Center Rd
Toledo, OH 43609
Phone (419) 241-4230

1020 Varland Ave
Toledo, OH 43605
Phone (419) 691-1429

117 Main St
Toledo, OH 43605
Phone (419) 691-1322

1415 Jefferson Ave
Toledo, OH 43604
Phone (419) 214-5700

1425 Starr Ave
Toledo, OH 43605
Phone (419) 259-4506

313 Jefferson Ave
Toledo, OH 43604
Phone (419) 214-1770

430 Nebraska Ave
Toledo, OH 43604
Phone (419) 671-5400

544 E Woodruff Ave
Toledo, OH 43604
Phone (419) 214-4673

732 South Ave
Toledo, OH 43609
Phone (419) 241-6106

Interoperability endpoints

  • Direct secure messaging: kemuntomokora@nha.allscriptsdirect.net

Organizations & group practices 10

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": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1295303386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041004",
            "telephone_number": "419-720-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041004",
            "telephone_number": "419-720-7883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 W Congress St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482263289",
            "country_code": "US",
            "telephone_number": "419-378-0947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOKORA",
        "first_name": "KEMUNTO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0027696",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704393156APP22",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0027696",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "OH",
            "license": "0027696",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.