Credo Care Health LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP03210 Issued in OH

Legal business name

CREDO CARE HEALTH LLC

Practice address

6 Big Oak LN
Milford, OH 45150-1418

Phone

(513) 807-2323

NPI assigned

Nov 23, 2015

Last updated

Nov 23, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Ann Kokenge, RN, MSN, APRN

Title

Medical Director

Phone

(513) 807-2323

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448236800000",
    "number": "1982078333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BIG OAK LN",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451501418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BIG OAK LN",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451501418",
            "telephone_number": "513-807-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREDO CARE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A",
        "authorized_official_last_name": "KOKENGE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "513-807-2323",
        "authorized_official_credential": "RN, MSN, APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP03210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Milford, OH
• Providers in Milford, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.