Chouchouna M Kalamba

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R193970 Issued in MD

Practice address

5301 Buckeystown Pike Ste 308
Frederick, MD 21704-8373

Phone

(301) 246-0423

Fax

(301) 637-3576

NPI assigned

Jul 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Peaceful Mental Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frederick, MD
  • NPI 1891556700

  MD, Psychiatric/Mental Health

  Medicare reassignment NPD Authorized official
• Kema Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frederick, MD
  • NPI 1609495381

  MD

  Medicare reassignment

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

{
    "created_epoch": "1657929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695513600000",
    "number": "1407580210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 BYRON CIR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047812",
            "telephone_number": "240-205-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 BUCKEYSTOWN PIKE STE 308",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048373",
            "telephone_number": "301-246-0423",
            "fax_number": "301-637-3576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3616 Byron Cir",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217047812",
            "country_code": "US",
            "telephone_number": "240-205-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALAMBA",
        "first_name": "CHOUCHOUNA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-16",
        "last_updated": "2023-09-24",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R193970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary M Kahl, LCPC
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc
• Kusum A. R. Kalavar, M.D.
• Amanda Diane Kallas, CRNP
• Natasha Kamal, M.D.
• Kadiatu Mayeni Kamara-Hill, MSN, CRNP, FNP-BC, F
• Fanta Kamara

• All providers in Frederick, MD
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.