Individual provider Active NPI

Janeth Kamenge, NP

  • Gerontology Nurse Practitioner
  • Tucker, GA
National Provider Identifier
1487395125
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN-NP709985 Issued in GA
Practice address
4424 Hugh Howell Rd Ste D
Tucker, GA 30084-4905
Phone
(888) 405-6396
Fax
(415) 252-7176
NPI assigned
Apr 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN-NP709985 GA Primary
Gerontology Nurse Practitioner 363LG0600X 2234971 MN
Primary Care Nurse Practitioner 363LP2300X 8728 MN

Addresses

Primary practice location

4424 Hugh Howell Rd Ste D
Tucker, GA 30084-4905

Mailing address

4424 Hugh Howell Rd Ste D
Tucker, GA 30084-4905
Phone (888) 405-6396

Other practice location 1

8611 W Point Douglas Rd S
Cottage Grove, MN 55016-4005
Phone (651) 458-1884

Other practice location 2

6097 Courtly Alcove Unit C
Woodbury, MN 55125-1977
Phone (763) 377-3657

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkamenge545608@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230329002747 MN Practitioner - Nurse Practitioner 0840664082 Reassigns benefits to 1 organization
I20260331000805 GA Practitioner - Nurse Practitioner 0840664082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iora Health Georgia PCGroup PAC ID 1850644394, 27 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

4424 Hugh Howell Rd
Suite D
Tucker, GA 30084-4905
Phone (404) 692-4466

8611 W Point Douglas Rd S
Cottage Grove, MN 55016-4005
Phone (651) 458-1884

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8728MNMDClinical Social Worker
APRN-NP709985GAMDGerontology Nurse Practitioner
2234971MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Jul 17, 2023 Accepting new patients
Allina Health System CurrentSince Jul 17, 2023 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

8611 W Point Douglas Rd S
Cottage Grove, MN 55016
Phone (651) 458-1884

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1487395125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 HUGH HOWELL RD STE D",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844905",
            "telephone_number": "888-405-6396",
            "fax_number": "415-252-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 HUGH HOWELL RD STE D",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844905",
            "telephone_number": "888-405-6396",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8611 W Point Douglas Rd S",
            "address_purpose": "LOCATION",
            "city": "Cottage Grove",
            "state": "MN",
            "postal_code": "550164005",
            "country_code": "US",
            "telephone_number": "651-458-1884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6097 Courtly Alcove Unit C",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551251977",
            "country_code": "US",
            "telephone_number": "763-377-3657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMENGE",
        "first_name": "JANETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "APRN-NP709985",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "2234971",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "8728",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkamenge545608@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "8611 W Point Douglas Rd S",
            "city": "Cottage Grove",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550164005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.