NPIMap

Individual provider Active NPI

Meno Mazemda Kouakeu, NP

  • Family Nurse Practitioner
  • Arlington, VA
National Provider Identifier
1710338546
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173643 Issued in VA
Practice address
1201 S Hayes St
Arlington, VA 22202-2700
Phone
(757) 292-9094
NPI assigned
Jun 22, 2016
Last updated
Jul 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024173643 PA
Family Nurse Practitioner 363LF0000X 0024173643 VA Primary

Addresses

Primary practice location

1201 S Hayes St
Arlington, VA 22202-2700

Mailing address

4007 1St St SW
Washington, DC 20032-1304
Phone (757) 292-9094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161101002670 VA Practitioner - Nurse Practitioner 0749576676 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

Practice addresses (Care Compare)

1541 High St
Portsmouth, VA 23704-3209
Phone (757) 393-6363

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024173643PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Portsmouth Community Health Center, Inc. Family Current Accepting new patients
Portsmouth Community Health Center Inc CurrentSince Nov 16, 2020 Accepting new patients
Portsmouth Community Health Center Inc CurrentSince Nov 16, 2020 Accepting new patients

Locations

1541 High St
Portsmouth, VA 23704
Phone (757) 393-6363

664 Lincoln St
Portsmouth, VA 23704
Phone (757) 393-6363

Interoperability endpoints

  • Direct secure messaging: meno.kouakeu@hrchc.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1710338546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 1ST ST SW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200321304",
            "telephone_number": "757-292-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S HAYES ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222022700",
            "telephone_number": "757-292-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUAKEU",
        "first_name": "MENO",
        "middle_name": "MAZEMDA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "0024173643",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.