Individual provider Active NPI

Lloyd T Mbanwi

  • Case Manager/Care Coordinator
  • Takoma Park, MD
National Provider Identifier
1053029991
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
6733 New Hampshire Ave Apt 1007
Takoma Park, MD 20912-2858
Phone
(240) 886-9515
NPI assigned
Nov 9, 2022
Last updated
Jun 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

6733 New Hampshire Ave Apt 1007
Takoma Park, MD 20912-2858

Mailing address

6733 New Hampshire Ave Apt 1007
Takoma Park, MD 20912-2858
Phone (240) 886-9515

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

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1053029991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6733 NEW HAMPSHIRE AVE APT 1007",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209122858",
            "telephone_number": "240-886-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6733 NEW HAMPSHIRE AVE APT 1007",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209122858",
            "telephone_number": "240-886-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBANWI",
        "first_name": "LLOYD",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-09",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.