Fatoumata Moukir Ndukwe, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704267630 Issued in MI

Practice address

24450 Evergreen Road
215
Southfield, MI 48075-2022

Phone

(248) 996-8076

NPI assigned

Jun 6, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vip Home Physicians PLLCGroup PAC ID 7416483813, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Vip Home Physicians PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1689496820
  Medicare reassignment Care Compare group NPD
• Heritage Care LLC

  • Home Health Agency
  • Van Buren Township, MI
  • NPI 1881486520
  NPD Authorized official
• Home Visiting Doctors PLLC

  • General Practice Physician
  • Southfield, MI
  • NPI 1134660376
  NPD (past)
• Ve Care, Inc

  • Home Health Agency
  • Pacifica, CA
  • NPI 1891262796
  NPD (past)

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1902398787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6581 FLORENCE LANE",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "48111",
            "telephone_number": "313-971-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24450 EVERGREEN ROAD",
            "address_2": "215",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752022",
            "telephone_number": "248-996-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUKWE",
        "first_name": "FATOUMATA",
        "middle_name": "MOUKIR",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704267630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "4704267630",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Padmini Kepul Nayak, MD
• Jemimmah Ndandu
• Carl Ndangoh, PHARM D
• Isabella Liyana Ndlebe, MD
• Camilla Ndocaj
• Kendall Elizabeth Neary, BEHAVIOR TECHNICIAN
• Anthony Leron Neely, D.D.S.
• Debra Nelms, NP
• Jasmine Nelson-Brock
• Alexis Nelson

• Nurse Practitioner in Southfield, MI
• Providers in Southfield, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.