Jemima a. Kankam, M.D. P.a.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

D030505 Issued in MD

Legal business name

JEMIMA A. KANKAM, M.D. P.A.

Practice address

13639 Baltimore Ave
Laurel, MD 20707-5095

Phone

(301) 604-4830

Fax

(301) 604-4929

NPI assigned

Oct 28, 2014

Last updated

Oct 28, 2014By 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

Dr. Jemima Kankam, M.D.NPI 1104947639

Title

President

Phone

(301) 604-4830

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jemima Kankam, MD

  • Psychiatry Physician
  • Laurel, MD
  • NPI 1104947639
  NPD Authorized official

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1992100325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13639 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075095",
            "telephone_number": "301-604-4830",
            "fax_number": "301-604-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13639 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075095",
            "telephone_number": "301-604-4830",
            "fax_number": "301-604-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEMIMA A. KANKAM, M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "KANKAM",
        "authorized_official_first_name": "JEMIMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-604-4830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D030505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169301800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jjdlightcare

• Psychiatry Physician in Laurel, MD
• Providers in Laurel, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.