Individual provider Active NPI

Marie Louise Tiaha Pondem

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1174069041
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA12553 Issued in DC
Practice address
7826 Eastern Ave NW Ste LL16
Washington, DC 20012-1328
Phone
(202) 723-1100
Fax
(202) 723-3271
NPI assigned
Jan 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X
Home Health Aide 374U00000X HHA12553 DC Primary

Addresses

Primary practice location

7826 Eastern Ave NW Ste LL16
Washington, DC 20012-1328

Mailing address

2101 I St NE Apt 6
Washington, DC 20002-3240
Phone (202) 702-4797

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
HHA12553DCMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Berhan Home Health Care Agency Inc Past Accepting new patients

Organizations & group practices 1

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": "1484524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1174069041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 I ST NE APT 6",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023240",
            "telephone_number": "202-702-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7826 EASTERN AVE NW STE LL16",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200121328",
            "telephone_number": "202-723-1100",
            "fax_number": "202-723-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIAHA PONDEM",
        "first_name": "MARIE LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-16",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA12553",
            "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 15, 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.