Individual provider Active NPI

Kenyatta Hough, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1669820957
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R155112 Issued in MD
Practice address
4340 Park Heights Avenue
Baltimore, MD 21215
Phone
(410) 542-8130
NPI assigned
May 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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 R155112 MD Primary

Addresses

Primary practice location

4340 Park Heights Avenue
Baltimore, MD 21215

Mailing address

10053 Corioli Way
Owings Mills, MD 21117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160808000505 MD Practitioner - Nurse Practitioner 4082908439 Reassigns benefits to 4 organizations
I20180319002160 DC Practitioner - Nurse Practitioner 4082908439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Rehab Consultants PLLCGroup PAC ID 6800220682, 251 clinicians

Practice addresses (Care Compare)

11150 Resort Rd
Ellicott City, MD 21042-2050
Phone (410) 461-7070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Midtown Health Inc CurrentSince Oct 2, 2017 Accepting new patients
Park Heights Medical Clinic LLC CurrentSince Jul 6, 2016 Accepting new patients
Comprehensive Rehab Consultants PLLC Family CurrentSince Jul 1, 2024 Accepting new patients
University of Maryland Emergency Medicine Associates, PA CurrentSince Oct 14, 2017 Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Aug 10, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

105 Penn St
Baltimore, MD 21201
Phone (410) 328-2387

821 N Eutaw St
Baltimore, MD 21201
Phone (410) 225-9185

4669 Falls Rd
Baltimore, MD 21209
Phone (410) 662-8606

4340 Park Heights Ave
Baltimore, MD 21215
Phone (410) 542-8130

301 International Cir
Hunt Valley, MD 21030
Phone (410) 433-2200

300 W Seminary Ave
Lutherville, MD 21093
Phone (410) 252-0440

L2540 Maryland
Columbus, OH 43260

Organizations & group practices 7

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1669820957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10053 CORIOLI WAY",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 PARK HEIGHTS AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "410-542-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGH",
        "first_name": "KENYATTA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R155112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.