Kwanza Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

KWANZA CLINIC LLC

Practice address

303 Cherrystone CT
Reisterstown, MD 21136-6211

Phone

(757) 667-9549

Fax

(410) 834-5631

NPI assigned

Apr 8, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Edwin Juma, DNP, CRNPNPI 1134781875

Title

CRNP

Phone

(757) 667-9549

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edwin O Juma, CRNP

  • Adult Health Nurse Practitioner
  • Reisterstown, MD
  • NPI 1134781875
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1396539987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 CHERRYSTONE CT",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366211",
            "telephone_number": "757-667-9549",
            "fax_number": "410-834-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 CHERRYSTONE CT",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366211",
            "telephone_number": "757-667-9549",
            "fax_number": "410-834-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWANZA CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "JUMA",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "CRNP",
        "authorized_official_telephone_number": "757-667-9549",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, CRNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Hilja Koski-Miller, LCSW-C
• Irina Koyfman, NP
• Virginia Kranz, MD
• Michele L. Kupfer, O.D.
• Jonathan D Kushner, MD
• Joey Lam
• Scott David Langlois, CRNA
• Tara Elizabeth Larkin, M.S. CCC-SLP
• Alexandra Brooke Lawyer
• Hanna Michelle Lee, PHARM D

• Primary Care Clinic/Center in Reisterstown, MD
• Providers in Reisterstown, MD by specialty
• Primary Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.