AUGUSTINE AHENKORAH (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1376118182

AUGUSTINE AHENKORAH (PMHNP-BC) is a healthcare provider. based in Fairfax, Virginia. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-BC. They hold a License No. 2023059114 (VA). The NPI Number for AUGUSTINE AHENKORAH (PMHNP-BC) is 1376118182

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
AUGUSTINE AHENKORAH (PMHNP-BC)
NPI
1376118182
Phone
(170) 205-9452
Address
4410 SHIRLEY GATE RD
Enumeration Date
24 May 2021
Last Update Date
12 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7036985220
Graduation Year
2023 (3 years ago)
PAC ID
5597119800
Group Practice PAC ID
9830184852
Professional Enrollment ID
I20231004003061
Address ID
VA220312228FA8500XAVEX403
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

Provider Addresses for AUGUSTINE AHENKORAH (PMHNP-BC)

  • 4410 SHIRLEY GATE RD

    FAIRFAX, VA 220305518

    Phone: (170) 205-9452

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 21 Open Payments records for all available years, with a total value of $482.

Total Amount is formed as General ($482) + Research ($0) + Ownership ($0) = $482.

Last reported payment date: 2024-08-13 • Largest payer in this snapshot: Corium, LLC ($92).

Total Amount

$482

General + Research + Ownership

Payments

21

Total payment records

General Amount

$482

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-13

Latest reported date

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: 2023-10-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20230920002238INurse PractitionerDCTBD
I20231004003061INurse PractitionerVATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 22030)

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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: 9830184852View full group profile
NameSpecialtyState
Nurse PractitionerMD
-VA
-VA
Nurse PractitionerVA
P S Y C H I A T R YVA
Mental Health CounselorVA
P S Y C H I A T R YVA
Clinical Social WorkerVA
Clinical PsychologistVA

Reviews

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Frequently asked questions

How is AUGUSTINE AHENKORAH (PMHNP-BC) identified in CMS data?
CMS-hosted NPPES data lists AUGUSTINE AHENKORAH (PMHNP-BC) with NPI 1376118182.
Is AUGUSTINE AHENKORAH (PMHNP-BC) listed as active for patients and plans?
The listing shows AUGUSTINE AHENKORAH (PMHNP-BC) as active in the NPI system.
What is AUGUSTINE AHENKORAH (PMHNP-BC) best known for clinically?
Directory data describes AUGUSTINE AHENKORAH (PMHNP-BC) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is AUGUSTINE AHENKORAH (PMHNP-BC) based?
AUGUSTINE AHENKORAH (PMHNP-BC) is tied to Fairfax, Virginia in the data we show; additional addresses may exist on the full record.
Is the information about AUGUSTINE AHENKORAH (PMHNP-BC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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