Individual provider Active NPI

Jemima Frimpong Kodua

  • Psychiatric/Mental Health Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1831966308
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023150880 Issued in MD
Practice address
1117 Futurity St
Frederick, MD 21702-2358
Phone
(240) 626-3286
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN966950 DC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023150880 MD Primary

Addresses

Primary practice location

1117 Futurity St
Frederick, MD 21702-2358

Mailing address

1117 Futurity St
Frederick, MD 21702-2358
Phone (240) 626-3286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240520002688 DC Practitioner - Nurse Practitioner 0345682563 Reassigns benefits to 1 organization
I20260123002057 MD Practitioner - Nurse Practitioner 0345682563 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

Practice addresses (Care Compare)

1117 Futurity St
Frederick, MD 21702-2358
Phone (240) 626-3286

14502 Greenview Dr
Suite 427
Laurel, MD 20708-3287
Phone (240) 626-3286

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN966950DCMDRegistered Nurse
2023150880MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Favor Loving Care Psychiatric/Mental Health CurrentSince Apr 15, 2024 Accepting new patients
Favor Loving Care CurrentSince Sep 15, 2024 Accepting new patients

Locations

14502 Greenview Dr
Ste 427
Laurel, MD 20708
Phone (240) 626-3286

Interoperability endpoints

  • Direct secure messaging: jemma.kodua.p1@direct.mcg-hhs.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1831966308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 FUTURITY ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022358",
            "telephone_number": "240-626-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 FUTURITY ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022358",
            "telephone_number": "240-626-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODUA",
        "first_name": "JEMIMA",
        "middle_name": "FRIMPONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN966950",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "2023150880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.