Individual provider Active NPI

Kelvin Draine

  • Health Service Psychologist
  • Washington, DC
National Provider Identifier
1396383287
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
Practice address
4800 Nannie Helen Burroughs Ave NE Apt 503
Washington, DC 20019-3772
Phone
(202) 553-5555
NPI assigned
Dec 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X Primary

Addresses

Primary practice location

4800 Nannie Helen Burroughs Ave NE Apt 503
Washington, DC 20019-3772

Mailing address

3535 21St St SE
Washington, DC 20020-6110
Phone (240) 573-8812

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

NPI Registry JSON

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1396383287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 21ST ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200206110",
            "telephone_number": "240-573-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 NANNIE HELEN BURROUGHS AVE NE APT 503",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193772",
            "telephone_number": "202-553-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAINE",
        "first_name": "KELVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.