Active NPI
Ennoble HC DMV LLC
- Geriatric Medicine (Family Medicine) Physician
- Fulton, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- Legal business name
- ENNOBLE HC DMV LLC
- Practice address
- 8115 Maple Lawn Blvd Ste 350
Fulton, MD 20759-2683 - Phone
- (862) 812-9010
- NPI assigned
- Jun 1, 2021
- Last updated
- Nov 26, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kush Das
- Title
- Manager
- Phone
- (201) 956-8233
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | Primary |
Addresses
Primary practice location
8115 Maple Lawn Blvd Ste 350
Fulton, MD 20759-2683
Mailing address
39 V St NE
Washington, DC 20002-1329
Phone (862) 812-9010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, GA, MD, VA
Enrollment records 4
National Provider Directory
National Provider DirectoryLocations
2002 Summit Blvd
Brookhaven, GA 30319
Phone (404) 882-8822
50 Glenlake Pkwy
Sandy Springs, GA 30328
Phone (678) 328-4100
50 Glenlake Pkwy
Ste 800
Sandy Springs, GA 30328
8101 Sandy Spring Rd
Ste 300W28
Laurel, MD 20707
962 Wayne Ave
Silver Spring, MD 20910
Phone (301) 585-9595
Practitioners & affiliated clinicians
Practitioners 162
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
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DC, Single Specialty
-
- Adult Health Nurse Practitioner
- Huntingtown, MD
- NPI 1558026542
DC, Multi-Specialty
-
- Family Nurse Practitioner
- Gaithersburg, MD
- NPI 1831478890
DC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1764115200000",
"number": "1104492115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 V ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200021329",
"telephone_number": "862-812-9010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8115 MAPLE LAWN BLVD STE 350",
"city": "FULTON",
"state": "MD",
"postal_code": "207592683",
"telephone_number": "862-812-9010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ENNOBLE HC DMV LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-01",
"last_updated": "2025-11-26",
"certification_date": "2025-11-26",
"status": "A",
"authorized_official_last_name": "DAS",
"authorized_official_first_name": "KUSH",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "201-956-8233"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fulton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.