Active NPI
Clarisse Masengo Mutombo
- Home Health Aide
- Hutto, TX
National Provider Identifier
1053693127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 150 Klattenhoff LN
3204
Hutto, TX 78634-4601 - Phone
- (917) 355-3458
- NPI assigned
- Sep 15, 2011
- Last updated
- Sep 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | |||
| Chore Provider | 372500000X | |||
| Adult Companion | 372600000X | |||
| Attendant Care Provider | 3747A0650X | |||
| Personal Care Attendant | 3747P1801X | |||
| Religious Nonmedical Practitioner | 374K00000X | |||
| Home Health Aide | 374U00000X | Primary |
Addresses
Primary practice location
150 Klattenhoff LN
3204
Hutto, TX 78634-4601
Mailing address
150 Klattenhoff LN
3204
Hutto, TX 78634-4601
Phone (917) 355-3458
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": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1053693127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 KLATTENHOFF LN",
"address_2": "3204",
"city": "HUTTO",
"state": "TX",
"postal_code": "786344601",
"telephone_number": "917-355-3458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 KLATTENHOFF LN",
"address_2": "3204",
"city": "HUTTO",
"state": "TX",
"postal_code": "786344601",
"telephone_number": "917-355-3458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUTOMBO",
"first_name": "CLARISSE",
"middle_name": "MASENGO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-15",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": false
},
{
"code": "374K00000X",
"taxonomy_group": "",
"desc": "Religious Nonmedical Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hutto, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.