Individual provider Active NPI

Sisay Teshome Kebede

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1124885249
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA200002979 Issued in DC
Practice address
820 Upshur St NW
Washington, DC 20011-5837
Phone
(202) 644-6322
NPI assigned
Mar 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA200002979 DC Primary

Addresses

Primary practice location

820 Upshur St NW
Washington, DC 20011-5837

Mailing address

820 Upshur St NW
Washington, DC 20011-5837
Phone (202) 644-6322

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

LicenseStateTypeSpecialty
HHA200002979DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1124885249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 UPSHUR ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115837",
            "telephone_number": "202-644-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 UPSHUR ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115837",
            "telephone_number": "202-644-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBEDE",
        "first_name": "SISAY",
        "middle_name": "TESHOME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA200002979",
            "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 5, 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.

Verify at the official NPI Registry.