Individual provider Active NPI

Fuanya R Mbakem, HHA

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1154815447
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA13756 Issued in DC
Practice address
3500 18TH St NE
Washington, DC 20018-2738
Phone
(202) 529-6510
Fax
(202) 529-6570
NPI assigned
Jun 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health AideGroup: 193400000X SINGLE SPECIALTY GROUP 374U00000X HHA13756 DC Primary

Addresses

Primary practice location

3500 18TH St NE
Washington, DC 20018-2738

Mailing address

4203 Windflower Way
Bowie, MD 20720-4293
Phone (240) 548-8291

Other identifiers 1

IdentifierTypeStateIssuer
HHA13756MedicaidDC

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
HHA13756DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1154815447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 WINDFLOWER WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204293",
            "telephone_number": "240-548-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 18TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200182738",
            "telephone_number": "202-529-6510",
            "fax_number": "202-529-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAKEM",
        "first_name": "FUANYA",
        "middle_name": "R",
        "name_prefix": "Miss",
        "credential": "HHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA13756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA13756",
            "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 Jun 19, 2018; 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.