Active NPI
Kanitra Myree
- Nurse Practitioner
- Temple Hills, MD
National Provider Identifier
1548638802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R136312
- Practice address
- 5312 Ludlow Dr
Temple Hills, MD 20748-2125 - Phone
- (301) 423-2850
- NPI assigned
- Sep 3, 2015
- Last updated
- Oct 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R136312 | MD | Primary |
Addresses
Primary practice location
5312 Ludlow Dr
Temple Hills, MD 20748-2125
Mailing address
5312 Ludlow Dr
Temple Hills, MD 20748-2125
Phone (301) 423-2850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R136312 | MD | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445299200000",
"number": "1548638802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5312 LUDLOW DR",
"city": "TEMPLE HILLS",
"state": "MD",
"postal_code": "207482125",
"telephone_number": "301-423-2850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5312 LUDLOW DR",
"city": "TEMPLE HILLS",
"state": "MD",
"postal_code": "207482125",
"telephone_number": "301-423-2850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYREE",
"first_name": "KANITRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-03",
"last_updated": "2015-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MD",
"license": "R136312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple Hills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.