Kelly Amike Ngenge, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R226054 Issued in MD

Practice address

107 Bierstadt CT
Frederick, MD 21702-6442

Phone

(512) 788-8867

NPI assigned

Aug 18, 2020

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mental Health Assoc of Frederick Cty

  • Mental Health Counselor
  • Frederick, MD
  • NPI 1821286675

  MD

  Medicare reassignment NPD
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483

  DC, MD

  Medicare reassignment NPD
• Roots of Hope LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frederick, MD
  • NPI 1376499376
  NPD Authorized official
• Mental Health Assoc of Frederick Cty

  • Clinical Social Worker
  • Frederick, MD
  • NPI 1568902260
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Mental Health Assoc of Frederick Cty

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frederick, MD
  • NPI 1902680051
  NPD (past)

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1689286197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BIERSTADT CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217026442",
            "telephone_number": "512-788-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BIERSTADT CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217026442",
            "telephone_number": "512-788-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGENGE",
        "first_name": "KELLY",
        "middle_name": "AMIKE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R226054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessa Marie Lynn Newton
• Theresa NG, PHARM.D
• Mirabelle Ringnyu Nkambfu Ngah
• Kenneth Ngong Ngam Ayeah
• Dominica Ngante
• Bradley T Nguyen
• Faith W Nguyen, CRNP
• Jessica Nguyen
• Joe Truong Nguyen, DDS, PHD
• Jankey Ceesay Niasse

• All providers in Frederick, MD
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.