Individual provider Active NPI

Lloyd Amaghionyeodiwe

  • Home Health Aide
  • Laurel, MD
National Provider Identifier
1144793209
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
R3743R Issued in MD
Practice address
14440 Cherry Lane CT Ste 102B
Laurel, MD 20707-4946
Phone
(240) 646-2214
Fax
(270) 650-0860
NPI assigned
Jan 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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 R3743R MD Primary

Addresses

Primary practice location

14440 Cherry Lane CT Ste 102B
Laurel, MD 20707-4946

Mailing address

14440 Cherry Lane CT Ste 102B
Laurel, MD 20707-4946
Phone (240) 646-2214

Other identifiers 1

IdentifierTypeStateIssuer
R3743RMedicaidMD

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
R3743RMDMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1144793209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14440 CHERRY LANE CT STE 102B",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074946",
            "telephone_number": "240-646-2214",
            "fax_number": "270-650-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14440 CHERRY LANE CT STE 102B",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074946",
            "telephone_number": "240-646-2214",
            "fax_number": "270-650-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAGHIONYEODIWE",
        "first_name": "LLOYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MD",
            "license": "R3743R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R3743R",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.