Individual provider Active NPI

Marvin Ddumba

  • Case Manager/Care Coordinator
  • Fredericksburg, VA
National Provider Identifier
1124735626
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
200 Morton Rd
Fredericksburg, VA 22405
Phone
(703) 887-3370
NPI assigned
Nov 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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 Primary

Addresses

Primary practice location

200 Morton Rd
Fredericksburg, VA 22405

Mailing address

10001 Georgetown Pike. PMB 432
Great Falls, VA 22066

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
Quantum Health Current Accepting new patients
Alliance Care LLC Current Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1124735626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 GEORGETOWN PIKE. PMB 432",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "22066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MORTON RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22405",
            "telephone_number": "703-887-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DDUMBA",
        "first_name": "MARVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-03",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.