Individual provider Active NPI

Beatrice Okoreeh-Kangah

  • Family Nurse Practitioner
  • Highland, CA
National Provider Identifier
1457520074
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16504 Issued in CA
Practice address
3606 Highland Ave Ste 108
Highland, CA 92346-2608
Phone
(612) 659-7111
NPI assigned
Feb 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 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 16504 CA Primary

Addresses

Primary practice location

3606 Highland Ave Ste 108
Highland, CA 92346-2608

Mailing address

3606 Highland Ave
Ste 108
Highland, CA 92346-2608
Phone (612) 659-7111

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

State licenses

LicenseStateTypeSpecialty
16504CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Redlands Community Hospital PastSince Aug 27, 2014 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15368/brand/1/csg/1/fhir/r4
  • Direct secure messaging: beatrice.okoreeh-kangah.1@15368.direct.athenahealth.com

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": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1457520074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 HIGHLAND AVE",
            "address_2": "STE 108",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923462608",
            "telephone_number": "612-659-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 HIGHLAND AVE STE 108",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923462608",
            "telephone_number": "612-659-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOREEH-KANGAH",
        "first_name": "BEATRICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "16504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.