Individual provider Active NPI

Kingsley Eyong Enow, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1477815892
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0031826 Issued in OH
Practice address
3505 E Livingston Ave Ste G
Columbus, OH 43227-2252
Phone
(614) 632-1018
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0031826 OH Primary

Addresses

Primary practice location

3505 E Livingston Ave Ste G
Columbus, OH 43227-2252

Mailing address

3505 E Livingston Ave Ste G
Columbus, OH 43227-2252
Phone (614) 715-8216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240503003589 OH Practitioner - Nurse Practitioner 9335593649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0031826OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Homeland Addiction Treatment Center LLC Psychiatric/Mental Health CurrentSince Jul 4, 2023 Accepting new patients
Homeland Addiction Treatment Center LLC Past Accepting new patients
Homeland Clinic Past Accepting new patients

Locations

3505 E Livingston Ave
Ste G
Columbus, OH 43227
Phone (614) 632-1018

Interoperability endpoints

  • Direct secure messaging: kingsley.enow.1@29652.direct.athenahealth.com

Organizations & group practices 3

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": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1477815892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 E LIVINGSTON AVE STE G",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432272252",
            "telephone_number": "614-715-8216",
            "fax_number": "614-715-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 E LIVINGSTON AVE STE G",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432272252",
            "telephone_number": "614-632-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENOW",
        "first_name": "KINGSLEY",
        "middle_name": "EYONG",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0031826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.