Idil A Jama

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

3969-001 Issued in VA

Practice address

4609 Guinea Rd
Annandale, VA 22003-3956

Phone

(703) 282-6389

NPI assigned

Sep 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rahma Group Home LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Annandale, VA
  • NPI 1215650270
  NPD Authorized official

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1164145280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 GUINEA RD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033956",
            "telephone_number": "703-282-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 GUINEA RD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033956",
            "telephone_number": "703-282-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMA",
        "first_name": "IDIL",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "VA",
            "license": "3969-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Jacobs, M.S.W.
• Jennifer Jacobs
• Jae Kwon Bok DDS PC
• Sharon A Jaeckel, PT
• Aabha Jain, M.D.
• Nadia Jamai
• Kayla James, MD
• Sarah-Ann Louder James
• Nicholas Jameson, PHARM.D.
• Julie Janes, PT, DPT

• Developmental Disabilities Clinic/Center in Annandale, VA
• Providers in Annandale, VA by specialty
• Developmental Disabilities Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.