Active NPI
Ethel Pelote-Johnson, NONE
- Personal Care Attendant
- Washington, DC
National Provider Identifier
1124530233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 2301 11TH St NW Apt 504
Washington, DC 20001-2223 - Phone
- (202) 285-5532
- NPI assigned
- Oct 30, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
2301 11TH St NW Apt 504
Washington, DC 20001-2223
Mailing address
1923 Glendora Dr
District Heights, MD 20747-1852
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 297383 | Medicaid | DC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509321600000",
"number": "1124530233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1923 GLENDORA DR",
"city": "DISTRICT HEIGHTS",
"state": "MD",
"postal_code": "207471852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 11TH ST NW APT 504",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200012223",
"telephone_number": "202-285-5532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELOTE-JOHNSON",
"first_name": "ETHEL",
"credential": "NONE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-30",
"last_updated": "2017-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "297383",
"state": "DC"
}
],
"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 Oct 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.