Individual provider Active NPI

Kadijatu Kawa

  • Licensed Practical Nurse
  • Columbus, OH
National Provider Identifier
1578737680
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN117869 Issued in OH
Practice address
2784 Berthstone CT
Columbus, OH 43231
Phone
(614) 626-1099
NPI assigned
Apr 18, 2008
Last updated
Nov 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN117869 OH Primary

Addresses

Primary practice location

2784 Berthstone CT
Columbus, OH 43231

Mailing address

2784 Berthstone CT
Columbus, OH 43231-8724
Phone (614) 626-1099

Other identifiers 1

IdentifierTypeStateIssuer
2652295MedicaidOH

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN117869OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kawa Home Health Care LLC CurrentSince Jul 21, 2024 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1578737680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2784 BERTHSTONE CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432318724",
            "telephone_number": "614-626-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2784 BERTHSTONE CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43231",
            "telephone_number": "614-626-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWA",
        "first_name": "KADIJATU",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN117869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2652295",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.