Active NPI
Jeminat Bose Momodu
- Home Health Aide
- Washington, DC
National Provider Identifier
1104686971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- HHA200003601
- Practice address
- 4740 Eastern Ave NE
Washington, DC 20017-3127 - Phone
- (240) 795-8932
- NPI assigned
- Mar 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HHA200003601 | DC | |
| Home Health Aide | 374U00000X | HHA200003601 | DC | Primary |
Addresses
Primary practice location
4740 Eastern Ave NE
Washington, DC 20017-3127
Mailing address
4740 Eastern Ave NE
Washington, DC 20017-3127
Phone (240) 795-8932
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 |
|---|---|---|---|
| HHA200003601 | DC | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711411200000",
"number": "1104686971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4740 EASTERN AVE NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200173127",
"telephone_number": "240-795-8932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4740 EASTERN AVE NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200173127",
"telephone_number": "240-795-8932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOMODU",
"first_name": "JEMINAT",
"middle_name": "BOSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-20",
"last_updated": "2024-03-26",
"certification_date": "2024-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "DC",
"license": "HHA200003601",
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "DC",
"license": "HHA200003601",
"primary": true
}
],
"identifiers": [],
"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 Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.