Individual provider Active NPI

Gadisa Gefa

  • Home Health Clinical Nurse Specialist
  • Olney, MD
National Provider Identifier
1053218933
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Clinical Nurse SpecialistTaxonomy code 364SH0200X
License
RN1058185 Issued in DC
Practice address
18053 Wagonwheel CT
Olney, MD 20832-2850
Phone
(240) 704-1446
NPI assigned
Oct 22, 2026
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Clinical Nurse Specialist 364SH0200X RN1058185 DC Primary

Addresses

Primary practice location

18053 Wagonwheel CT
Olney, MD 20832-2850

Mailing address

18053 Wagonwheel CT
Olney, MD 20832-2850
Phone (240) 704-1446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1792627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1053218933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18053 WAGONWHEEL CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208322850",
            "telephone_number": "240-704-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18053 WAGONWHEEL CT",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208322850",
            "telephone_number": "240-704-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEFA",
        "first_name": "GADISA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-22",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "DC",
            "license": "RN1058185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.