Individual provider Active NPI

Gwendoline Wubnyonga Tankoh

  • Case Manager/Care Coordinator
  • Capitol Heights, MD
National Provider Identifier
1114895117
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
4411 Southern Ave
Capitol Heights, MD 20743-5639
Phone
(301) 379-8697
NPI assigned
Oct 29, 2025
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X MD Primary

Addresses

Primary practice location

4411 Southern Ave
Capitol Heights, MD 20743-5639

Mailing address

4411 Southern Ave
Capitol Heights, MD 20743-5639
Phone (301) 379-8697

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yebacam Healthcare LLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1114895117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 SOUTHERN AVE",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207435639",
            "telephone_number": "301-379-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SOUTHERN AVE",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207435639",
            "telephone_number": "301-379-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKOH",
        "first_name": "GWENDOLINE",
        "middle_name": "WUBNYONGA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitol Heights, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.