Individual provider Active NPI

Naomi Jepkorir Mutai

  • Family Nurse Practitioner
  • Chantilly, VA
National Provider Identifier
1407379134
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-77544-102 Issued in KS
Practice address
14121 Parke Long CT Ste 201
Chantilly, VA 20151-1647
Phone
(855) 247-1940
Fax
(844) 379-5385
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-77544-102 KS Primary

Addresses

Primary practice location

14121 Parke Long CT Ste 201
Chantilly, VA 20151-1647

Mailing address

1502 W Mulberry St
Olathe, KS 66061-2571
Phone (913) 549-3232

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-77544-102KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hands of Hope Home Health LLC CurrentSince Dec 22, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1407379134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W MULBERRY ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660612571",
            "telephone_number": "913-549-3232",
            "fax_number": "913-732-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14121 PARKE LONG CT STE 201",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511647",
            "telephone_number": "855-247-1940",
            "fax_number": "844-379-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTAI",
        "first_name": "NAOMI",
        "middle_name": "JEPKORIR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77544-102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; 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.