Kevin Obi NP in Psychiatry PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

KEVIN OBI NP IN PSYCHIATRY PLLC

Practice address

682 E 241St St
Bronx, NY 10470-1030

Phone

(973) 342-5593

NPI assigned

Feb 9, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Obi, MSNNPI 1679062640

Title

Nurse Practitioner in Psychiatry

Phone

(973) 342-5593

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Obi

  • Psychiatric/Mental Health Nurse Practitioner
  • Union, NJ
  • NPI 1679062640

  NY

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1639823412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 ELKER RD",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835006",
            "telephone_number": "973-342-5593",
            "fax_number": "646-490-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 E 241ST ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701030",
            "telephone_number": "973-342-5593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4377 Bronx Blvd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104661397",
            "country_code": "US",
            "telephone_number": "347-912-7566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KEVIN OBI NP IN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "OBI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER IN PSYCHIATRY",
        "authorized_official_telephone_number": "973-342-5593",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5427909",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "csv",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4377 Bronx Blvd",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104661397",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kobi@canaanmedical.com",
            "affiliation": "N",
            "address_1": "682 E 241st St",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104701030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Scott Ketner Jr., M.D.
• Khadejha Ketter
• Nicole Chantell Ketter, LMSW
• Sarah Kevelson, M.D.
• Kevin L Cintron Rd LLC
• Leyam Theresa Kewson, M.D.
• Nancy Key, LCSW
• Keystone Podiatry
• Anna Kezerashvili, M.D.
• Madina Khabiyeva

• Psychiatric/Mental Health Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.