Katendi Kanema, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71011886A Issued in IN

Practice address

6910 N Main St Unit 52
Granger, IN 46530-8412

Phone

(574) 231-6766

Fax

(833) 249-2411

NPI assigned

Nov 18, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Great Lakes Behavior Management Specialists, Inc.Group PAC ID 9436580958, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Great Lakes Behavior Management Specialists, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Granger, IN
  • NPI 1891346441
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641600000000",
    "number": "1609533298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52021 CLOVERLEAF DR W",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466376034",
            "telephone_number": "574-231-6766",
            "fax_number": "833-249-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 N MAIN ST UNIT 52",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308412",
            "telephone_number": "574-231-6766",
            "fax_number": "833-249-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANEMA",
        "first_name": "KATENDI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2022-01-08",
        "certification_date": "2022-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011886A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "71011866A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "GLBMS",
            "affiliation": "N",
            "address_1": "6910 N Main St Unit 52",
            "city": "Granger",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465308412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa Lynne Jodway, CPNP
• Charisse D Johnson, MD
• Bruce Joray, LCSW
• Jeanette Josol Jumao-As, PT
• Kelsey L Jurgonski, NP
• Melissa Elizabeth Karasek, LMT
• Emilia M Kareem, PT
• Alison Marie Kartz, HIS
• Kevin P Kaufhold, MD
• Shanna Verma Kautzmann, M.D.

• Family Nurse Practitioner in Granger, IN
• Providers in Granger, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.