Active NPI
Louis Afumbom Kimeng
- Licensed Practical Nurse
- College Park, MD
National Provider Identifier
1720411523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP50021
- Practice address
- 4920 Niagara Rd
Suite 318
College Park, MD 20740-1110 - Phone
- (301) 982-6477
- Fax
- (301) 982-6488
- NPI assigned
- Aug 15, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP50021 | MD | Primary |
Addresses
Primary practice location
4920 Niagara Rd
Suite 318
College Park, MD 20740-1110
Mailing address
4920 Niagara Rd
Suite 318
College Park, MD 20740-1110
Phone (301) 982-6477
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP50021 | MD | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376524800000",
"number": "1720411523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4920 NIAGARA RD",
"address_2": "SUITE 318",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207401110",
"telephone_number": "301-982-6477",
"fax_number": "301-982-6488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4920 NIAGARA RD",
"address_2": "SUITE 318",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207401110",
"telephone_number": "301-982-6477",
"fax_number": "301-982-6488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMENG",
"first_name": "LOUIS",
"middle_name": "AFUMBOM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-15",
"last_updated": "2013-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MD",
"license": "LP50021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.