GHISLAINE KENMEGNE DATOUO MOGO – Psychiatric/Mental Health Nurse Practitioner, NPI 1164064705

GHISLAINE KENMEGNE DATOUO MOGO is a healthcare provider. based in Laurel, Maryland. specializing in NURSE PRACTITIONER. They hold a License No. RN1028252 (DC). The NPI Number for GHISLAINE KENMEGNE DATOUO MOGO is 1164064705

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
GHISLAINE KENMEGNE DATOUO MOGO
NPI
1164064705
Phone
(240) 705-1096
Address
9580 MUIRKIRK RD APT 101
Enumeration Date
15 October 2019
Last Update Date
15 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
52079232931308
Graduation Year
2023 (3 years ago)
PAC ID
3375900137
Group Practice PAC ID
9537131198
Professional Enrollment ID
I20230609000559
Address ID
AZ857111448TU620XXRDXX400

Contacts

Other Endpoint
Washington
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:6State licenses:1Other namesUpdated within 12 months

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Provider Addresses for GHISLAINE KENMEGNE DATOUO MOGO

  • 9580 MUIRKIRK RD APT 101

    LAUREL, MD 207082717

    Phone: (240) 705-1096

    Type: Mailing

  • 4130, Hunt Place Northeast, Central Northeast, Washington, Washington, D.C., 20019, United States

    WASHINGTON, DC 200193565

    Phone: (202) 679-0620

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $125.

Total Amount is formed as General ($125) + Research ($0) + Ownership ($0) = $125.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($125).

Total Amount

$125

General + Research + Ownership

Payments

1

Total payment records

General Amount

$125

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-06-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230609000559INurse PractitionerAZTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes1313$0
View full utilization report →

Insurance plans in this area (ZIP 20708)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537131198View full group profile
NameSpecialtyState
-AZ
Nurse PractitionerAZ
-TX
-AZ
Nurse PractitionerAZ
P S Y C H I A T R YPA
Nurse PractitionerAZ
Addiction Medicine, PsychiatryAZ
Nurse PractitionerAZ
Nurse PractitionerAZ

Reviews

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Frequently asked questions

Can I verify GHISLAINE KENMEGNE DATOUO MOGO with an NPI only?
You can start verification with NPI 1164064705 for GHISLAINE KENMEGNE DATOUO MOGO, then check state licensing separately.
Can I rely on GHISLAINE KENMEGNE DATOUO MOGO being an active provider?
As of the registry snapshot, GHISLAINE KENMEGNE DATOUO MOGO is marked active.
What healthcare role does GHISLAINE KENMEGNE DATOUO MOGO hold?
Scheduling teams often label GHISLAINE KENMEGNE DATOUO MOGO under Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does GHISLAINE KENMEGNE DATOUO MOGO serve?
GHISLAINE KENMEGNE DATOUO MOGO's listing highlights Laurel, Maryland; more addresses can appear in NPPES.
Why does GHISLAINE KENMEGNE DATOUO MOGO have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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