Kevine Raissa Makougang II

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1836 Metzerott Rd Apt 1727
Adelphi, MD 20783-3452

Phone

(267) 339-8410

NPI assigned

Feb 14, 2022

Reactivated

Jul 11, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1821743436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 METZEROTT RD APT 1727",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207833452",
            "telephone_number": "267-339-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 METZEROTT RD APT 1727",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207833452",
            "telephone_number": "267-339-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKOUGANG",
        "first_name": "KEVINE",
        "middle_name": "RAISSA",
        "name_prefix": "Ms.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "deactivation_date": "2023-06-26",
        "reactivation_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Adelphi, MD
• Providers in Adelphi, MD by specialty
• Case Manager/Care Coordinator in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.