Individual provider Active NPI

Keju Nkemtaji

  • Case Manager/Care Coordinator
  • Lanham, MD
National Provider Identifier
1790550143
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
9940 Park St
Lanham, MD 20706-4732
Phone
(202) 747-8097
NPI assigned
Nov 15, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

9940 Park St
Lanham, MD 20706-4732

Mailing address

9940 Park St
Lanham, MD 20706-4732
Phone (202) 747-8097

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

NPI Registry JSON

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1790550143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9940 PARK ST",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207064732",
            "telephone_number": "202-747-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9940 PARK ST",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207064732",
            "telephone_number": "202-747-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKEMTAJI",
        "first_name": "KEJU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-15",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.