Individual provider Active NPI

Ruth Woldeyohannes Mebrahtu

  • Home Health Aide
  • Silver Spring, MD
National Provider Identifier
1073164794
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA13392 Issued in DC
Practice address
1093 Ruatan St
Silver Spring, MD 20903-3224
Phone
(651) 757-8410
NPI assigned
Sep 24, 2019
Last updated
Oct 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA13392 DC Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

1093 Ruatan St
Silver Spring, MD 20903-3224

Mailing address

1093 Ruatan St
Silver Spring, MD 20903-3224
Phone (651) 757-8410

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

LicenseStateTypeSpecialty
HHA13392DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1073164794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 RUATAN ST",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209033224",
            "telephone_number": "651-757-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 RUATAN ST",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209033224",
            "telephone_number": "651-757-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEBRAHTU",
        "first_name": "RUTH",
        "middle_name": "WOLDEYOHANNES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA13392",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.