Jude Thaddeus Yusimbom Song, HOME HEALTH AIDE

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN200002497 Issued in DC

Practice address

2811 Pennsylvania Ave SE
Washington, DC 20020-3865

Phone

(202) 894-6811

Fax

(202) 894-6811

NPI assigned

Jan 4, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1033626635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 DORIS CT",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207101649",
            "telephone_number": "240-825-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 PENNSYLVANIA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200203865",
            "telephone_number": "202-894-6811",
            "fax_number": "202-894-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JUDE THADDEUS",
        "middle_name": "YUSIMBOM",
        "credential": "HOME HEALTH AIDE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-04",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA13466",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "DC",
            "license": "256963753",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DC",
            "license": "LPN200002497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith M. Sondheimer, MD
• Margarete Nzelle Sone
• Pamela Sone
• Boh Song, PHARMD
• David H Song, MD
• Judy H Song, M.D.
• Shuojing Song
• Sophia Qinghui Song, MD
• Sue Song
• Mwasi Songambele

• Licensed Practical Nurse in Washington, DC
• Providers in Washington, DC by specialty
• Licensed Practical Nurse in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.