Freddy Kabasele Kalonji, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R187142 Issued in MD

Practice address

5652 Country Farm Rd
White Marsh, MD 21162-1716

Phone

(410) 227-2101

NPI assigned

Jul 1, 2024

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1609612589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5652 COUNTRY FARM RD",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211621716",
            "telephone_number": "410-227-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5652 COUNTRY FARM RD",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211621716",
            "telephone_number": "410-227-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABASELE KALONJI",
        "first_name": "FREDDY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R187142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irene Services
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• Jewels Therapy Clinic, Inc.
• Erica Patrice Jones, LGPC
• Latoria Ann Jones, LMSW
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc (White Marsh Medical Center Pharmacy)
• Gregory B Kelly, MD
• Kindness My Son's Legacy
• Lisa M Koulish, MD
• Samuel Kpechi, REGISTERED NURSE

• Registered Nurse in White Marsh, MD
• Providers in White Marsh, MD by specialty
• Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.