Samoumimmi Juliette Coulibaly

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

HHA14678 Issued in DC

Practice address

1100 New Jersey Ave SE Ste 845
Washington, DC 20003-3338

Phone

(202) 545-6980

NPI assigned

Jun 15, 2020

Last updated

Jun 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Washington, DC
  • NPI 1730290883
  NPD (past)

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1104441195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 KENILWORTH AVE NE APT 152",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200191518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NEW JERSEY AVE SE STE 845",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200033338",
            "telephone_number": "202-545-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULIBALY",
        "first_name": "SAMOUMIMMI",
        "middle_name": "JULIETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA14678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Joseph Coughlin
• Assetou Coulibaly
• Fairaila Coulibaly
• Harouna Coulibaly
• Mariame Coulibaly
• Monica Ann Coulombe, PHARM.D.
• Allison Anne Coulter, M.D.
• Kinsey Hope Coulter
• Kirsty Coulter, PHD
• Susan K. Coulter, PH.D.

• Home Health Aide in Washington, DC
• Providers in Washington, DC by specialty
• Home Health Aide in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.