Daijon Bibbs

Key facts

NPI

1073373544

Entity type

Individual (NPI type 1)

Primary specialty

Case Manager/Care Coordinator 171M00000X

Practice address

320 Old Forge LN Apt 4202
Odenton, MD 21113-2983

Phone

(202) 423-9410

NPI assigned

Mar 20, 2024

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 20, 2024.

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1073373544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 OLD FORGE LN APT 4202",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211132983",
            "telephone_number": "202-423-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 OLD FORGE LN APT 4202",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211132983",
            "telephone_number": "202-423-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBBS",
        "first_name": "DAIJON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Odenton, MD · Case Manager/Care Coordinator in Maryland