Individual provider Active NPI

Kokouvi Hiheglo, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Bethesda, MD
National Provider Identifier
1649020850
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R239579 Issued in MD
Practice address
6701 Democracy Blvd Ste 300
Bethesda, MD 20817-7500
Phone
(646) 941-7645
NPI assigned
Mar 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 787140 MD
Child & Adolescent Psychiatry Physician 2084P0804X 787140 MD
Geriatric Psychiatry Physician 2084P0805X 787140 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R239579 MD Primary

Addresses

Primary practice location

6701 Democracy Blvd Ste 300
Bethesda, MD 20817-7500

Mailing address

7661 Arundel Mills Blvd
Hanover, MD 21076-1305
Phone (667) 225-0673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240530000768 MD Practitioner - Nurse Practitioner 4183066509 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Norkris Services IncGroup PAC ID 3375848625, 6 clinicians

Practice addresses (Care Compare)

611 S Union Ave
Havre de Grace, MD 21078-3421
Phone (443) 526-6133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
787140MDMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Resonance Behavioral Health Services Psychiatric/Mental Health CurrentSince May 1, 2024 Accepting new patients
Norkris Services, Inc Psychiatric/Mental Health CurrentSince Feb 1, 2025 Accepting new patients

Locations

611 S Union Ave
Hvre de Grace, MD 21078
Phone (443) 526-6133

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": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1649020850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7661 ARUNDEL MILLS BLVD",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761305",
            "telephone_number": "667-225-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 DEMOCRACY BLVD STE 300",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177500",
            "telephone_number": "646-941-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIHEGLO",
        "first_name": "KOKOUVI",
        "name_prefix": "Mr.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "787140",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "787140",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MD",
            "license": "787140",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R239579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.