Individual provider Active NPI

Joel Foncha Mundoh

  • Home Health Aide
  • Bladensburg, MD
National Provider Identifier
1023676749
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA14552 Issued in DC
Practice address
5000 Townsend Way Apt A1
Bladensburg, MD 20710-1885
Phone
(202) 294-4877
NPI assigned
May 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA14552 DC Primary

Addresses

Primary practice location

5000 Townsend Way Apt A1
Bladensburg, MD 20710-1885

Mailing address

5000 Townsend Way Apt A1
Bladensburg, MD 20710-1885
Phone (202) 294-4877

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
HHA14552DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1023676749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 TOWNSEND WAY APT A1",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207101885",
            "telephone_number": "202-294-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 TOWNSEND WAY APT A1",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207101885",
            "telephone_number": "202-294-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDOH",
        "first_name": "JOEL",
        "middle_name": "FONCHA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA14552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bladensburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.

Verify at the official NPI Registry.