Active NPI
Mbongo Emmaculate
- Home Health Aide
- Washington, DC
National Provider Identifier
1083129548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- HHA13296
- Practice address
- 2010 Rhode Island Ave NE
Washington, DC 20018-2835 - Phone
- (301) 339-4395
- NPI assigned
- Dec 6, 2017
- Last updated
- Jun 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | HHA13296 | DC | Primary |
Addresses
Primary practice location
2010 Rhode Island Ave NE
Washington, DC 20018-2835
Mailing address
2623 Nicholson St Apt 202
Hyattsville, MD 20782-2655
Phone (240) 714-2322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E-524-596-015-898 | Other | MD | ID CARD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| HHA13296 | DC | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1083129548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2623 NICHOLSON ST APT 202",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207822655",
"telephone_number": "240-714-2322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 RHODE ISLAND AVE NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200182835",
"telephone_number": "301-339-4395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMMACULATE",
"first_name": "MBONGO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-06",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "DC",
"license": "HHA13296",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ID CARD",
"identifier": "E-524-596-015-898",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.