Active NPI
Kenechukwu Charles Amandibuogu, HHA
- Home Health Aide
- Washington, DC
National Provider Identifier
1043866213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- HHA14448
- Practice address
- 1731 Bunker Hill Rd NE
Washington, DC 20017-3026 - Phone
- (202) 635-5756
- Fax
- (202) 635-5780
- NPI assigned
- Aug 14, 2019
- Last updated
- Aug 14, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | HHA14448 | DC | Primary |
Addresses
Primary practice location
1731 Bunker Hill Rd NE
Washington, DC 20017-3026
Mailing address
1731 Bunker Hill Rd NE
Washington, DC 20017-3026
Phone (202) 635-5756
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HHA14448 | Other | DC | HHA LICENSE |
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 |
|---|---|---|---|
| HHA14448 | DC | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565740800000",
"number": "1043866213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1731 BUNKER HILL RD NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200173026",
"telephone_number": "202-635-5756",
"fax_number": "202-635-5780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1731 BUNKER HILL RD NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200173026",
"telephone_number": "202-635-5756",
"fax_number": "202-635-5780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMANDIBUOGU",
"first_name": "KENECHUKWU",
"middle_name": "CHARLES",
"credential": "HHA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-14",
"last_updated": "2019-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "DC",
"license": "HHA14448",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HHA LICENSE",
"identifier": "HHA14448",
"state": "DC"
}
],
"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 Aug 14, 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.