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DR. KHADIJAH SV ENOH MD
NPI 1629828769
Student in an Organized Health Care Education/Training Program in Green Bay, WI

Active since March 22, 2024PECOS Enrolled
2851 UNIVERSITY AVE, GREEN BAY, WI 54311(414) 955-7236 Get Directions Write a Review

NPPES record last updated: March 22, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Khadijah Sv Enoh Md NPPES

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

DR. KHADIJAH SV ENOH MD (NPI 1629828769) is an individual student in an organized health care education/training program in Green Bay, Wisconsin and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629828769
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. KHADIJAH SV ENOHCredential: MD
Location Address2851 UNIVERSITY AVEGreen Bay, WI 54311-5855
Mailing Address2851 University AveGreen Bay, WI 54311-5855 · (414) 955-7236
Phone(414) 955-7236
Sole ProprietorNo
Enumeration DateMarch 22, 2024
NPPES CertifiedMarch 22, 2024
✔ NPI 1629828769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2851 UNIVERSITY AVE, Green Bay, WI 54311
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Khadijah Sv Enoh Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. KATHLEEN STOCKMAN MSW, LCSW, CSAC
Counselor (Addiction (Substance Use Disorder))
2851 UNIVERSITY AVE
GREEN BAY, WI 54311
Brown County (920) 431-2500
HOLLY SAGE MSW, APSW
Social Worker (Clinical)
2851 UNIVERSITY AVE
GREEN BAY, WI 54311
Brown County (920) 431-2500
MILWAUKEE VAMC
Clinic/Center (VA)
2851 UNIVERSITY AVE
GREEN BAY, WI 54311
Brown County (608) 821-7200
DR. KATELYN ELLEN NICHOLS PHARMD
Pharmacist (Ambulatory Care)
2851 UNIVERSITY AVE
GREEN BAY, WI 54311
Brown County (920) 431-2500
KRISTINE ANN MILLER MSW
Social Worker
2851 UNIVERSITY AVE
GREEN BAY, WI 54311
Brown County (920) 431-2500
DR. RYAN MICHAEL PROUTY PHARM.D.
Pharmacist (Pharmacotherapy)
2851 UNIVERSITY AVE
GREEN BAY, WI 54311
Brown County (920) 431-2500
AMANDA RYAN
Clinic/Center (VA)
2851 UNIVERSITY AVE
GREEN BAY, WI 54311
Brown County (716) 440-4117
KELSEY STOEGER RD CD
Dietitian, Registered
2851 UNIVERSITY AVE
GREEN BAY, WI 54311
Brown County (920) 431-2740

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 Khadijah Enoh's NPI number?

The NPI number for Khadijah Enoh is 1629828769. It was assigned to this individual provider in the NPPES registry on March 22, 2024.

Where is Khadijah Enoh located?

Khadijah Enoh practices at 2851 University Ave, Green Bay, WI 54311. The listed phone number is (414) 955-7236.

What is Khadijah Enoh's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Khadijah Enoh enrolled in Medicare?

Yes. Khadijah Enoh is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Khadijah Enoh was last updated on March 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.