Active NPI
Sulliz Nkwomboh Edeity
- Home Health Aide
- Washington, DC
National Provider Identifier
1003458969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- HHA14419
- Practice address
- 845 21St St NE
Washington, DC 20002-4168 - Phone
- (240) 486-7890
- NPI assigned
- Oct 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | HHA14419 | DC | Primary |
Addresses
Primary practice location
845 21St St NE
Washington, DC 20002-4168
Mailing address
2320 Brooke Grove Rd
Bowie, MD 20721-1859
Phone (240) 548-8100
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
| License | State | Type | Specialty |
|---|---|---|---|
| HHA14419 | DC | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570752000000",
"number": "1003458969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2320 BROOKE GROVE RD",
"city": "BOWIE",
"state": "MD",
"postal_code": "207211859",
"telephone_number": "240-548-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "845 21ST ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200024168",
"telephone_number": "240-486-7890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDEITY",
"first_name": "SULLIZ",
"middle_name": "NKWOMBOH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-11",
"last_updated": "2019-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "DC",
"license": "HHA14419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.