Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KAIROS HEALTHCARE SERVICES LLC
NPI 1063170272
Nurse Practitioner - Psychiatric/Mental Health in Waldorf, MD

Q: What is Kairos Healthcare Services LLC's NPI number?

The NPI number for Kairos Healthcare Services LLC is 1063170272. It was assigned to this organization in the NPPES registry on December 4, 2021. The provider is doing business as Kairos Healthcare Services.

Q: What is Kairos Healthcare Services LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since December 04, 2021

11355 PEMBROOKE SQ STE 109, WALDORF, MD 20603(240) 544-8190(240) 200-7862 Get Directions Write a Review

NPPES record last updated: October 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 9, 2024, May 3, 2023, Dec 4, 2021 (3 updates tracked since 2021).

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About Kairos Healthcare Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAIROS HEALTHCARE SERVICES LLC (NPI 1063170272), doing business as Kairos Healthcare Services, is a healthcare organization registered as a psychiatric/mental health in Waldorf, Maryland and active in the NPI registry since December 2021. The organization maintains a secondary practice location in Manassas and lists Ogechukwu I Igbo, Psychiatric Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1063170272

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameKAIROS HEALTHCARE SERVICES LLC

Location Address11355 PEMBROOKE SQ STE 109Waldorf, MD 20603-4805

Mailing Address10601 Birdie LnUpper Marlboro, MD 20774-6022 · (240) 544-8190 · Fax (240) 200-7862

Phone(240) 544-8190

Fax(240) 200-7862

Organization SubpartNo

Authorized OfficialOgechukwu I IgboPsychiatric Nurse Practitioner · (240) 544-8190

Enumeration DateDecember 4, 2021

Last NPPES UpdateOctober 23, 20263 updates tracked since enumeration

NPPES CertifiedOctober 23, 2026

✔ NPI 1063170272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

11355 PEMBROOKE SQ STE 109, Waldorf, MD 20603

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Other Names 1

Doing Business AsKairos Healthcare Services

Secondary Practice Location 1

Location 110432 Balls Ford RdManassas, VA 20109-2514 · Phone (240) 544-8190 · Fax (240) 200-7862

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kairos Healthcare Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kairos Healthcare Services LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ogechukwu Igbo, PMHNP

Nurse Practitioner

NPI 1730781857

3300 GALLOWS RD
Falls Church, VA 22042

(703) 776-4001

✔ PECOS✔ Accepts Medicare24 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kairos Healthcare Services LLC's NPI number?

The NPI number for Kairos Healthcare Services LLC is 1063170272. It was assigned to this organization in the NPPES registry on December 4, 2021. The provider is doing business as Kairos Healthcare Services.

Where is Kairos Healthcare Services LLC located?

Kairos Healthcare Services LLC is located at 11355 Pembrooke Sq Ste 109, Waldorf, MD 20603. The listed phone number is (240) 544-8190.

What is Kairos Healthcare Services LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kairos Healthcare Services LLC enrolled in Medicare?

Yes. Kairos Healthcare Services LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kairos Healthcare Services LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Kairos Healthcare Services LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Kairos Healthcare Services LLC was last updated on October 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.