Individual provider Active NPI

Marthe Cathy Sooh Nkongo, APRN

  • Family Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1639933997
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12590 Issued in CT
Practice address
1106 North Ave
Bridgeport, CT 06604-2710
Phone
(203) 870-8430
NPI assigned
Feb 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12590 CT Primary

Addresses

Primary practice location

1106 North Ave
Bridgeport, CT 06604-2710

Mailing address

1106 North Ave
Bridgeport, CT 06604-2710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20240715001300 CT Practitioner - Nurse Practitioner 9830634815 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South-West Community Health Center, Inc CurrentSince Feb 24, 2025 Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

1020 Fairfield Ave
Bridgeport, CT 06605
Phone (203) 332-4600

46 Albion St
Bridgeport, CT 06605
Phone (203) 332-3155

510 Clinton Ave
Bridgeport, CT 06605
Phone (203) 366-4000

Interoperability endpoints

  • Direct secure messaging: mnkongo770707@direct.ochin.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1639933997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 NORTH AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 NORTH AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042710",
            "telephone_number": "203-870-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOH NKONGO",
        "first_name": "MARTHE",
        "middle_name": "CATHY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "12590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.