Individual provider Active NPI

Divine Abei Essem, REGISTERED NURSE

  • Registered Nurse
  • Beltsville, MD
National Provider Identifier
1003007113
Registry record updated Feb 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN1055512 Issued in DC
Practice address
11312 Evans TRL Apt 101
Beltsville, MD 20705-3008
Phone
(240) 421-5901
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP40279 MD
Registered Nurse 163W00000X RN1055512 DC Primary

Addresses

Primary practice location

11312 Evans TRL Apt 101
Beltsville, MD 20705-3008

Mailing address

11310 Evans TRL
Apt 102
Beltsville, MD 20705-3007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN1055512DCMDRegistered Nurse
LP40279MDMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1003007113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11310 EVANS TRL",
            "address_2": "APT 102",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207053007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11312 EVANS TRL APT 101",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207053008",
            "telephone_number": "240-421-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESSEM",
        "first_name": "DIVINE",
        "middle_name": "ABEI",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MD",
            "license": "LP40279",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1055512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beltsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; 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.