Active NPI
Jemal Demma Kimmo, PHARMD
- Pharmacist
- Washington, DC
National Provider Identifier
1699483396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH100001647
- Practice address
- 3839 Minnesota Ave NE
Washington, DC 20019-2660 - Phone
- (202) 388-1900
- Fax
- (202) 388-8099
- NPI assigned
- Nov 10, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH100001647 | DC | Primary |
Addresses
Primary practice location
3839 Minnesota Ave NE
Washington, DC 20019-2660
Mailing address
6733 New Hampshire Ave Apt 410
Takoma Park, MD 20912-2845
Phone (202) 372-6871
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH100001647 | DC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matrix Corporation | Current | Accepting new patients | |
| Matrix Corporation | Past | Accepting new patients |
Locations
3839 Minnesota Ave NE
Washington, DC 20019
Phone (202) 388-1900
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1699483396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6733 NEW HAMPSHIRE AVE APT 410",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209122845",
"telephone_number": "202-372-6871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3839 MINNESOTA AVE NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200192660",
"telephone_number": "202-388-1900",
"fax_number": "202-388-8099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMMO",
"first_name": "JEMAL",
"middle_name": "DEMMA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-10",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DC",
"license": "PH100001647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.