Individual provider Active NPI

Fumi B Jibodu

  • Home Health Aide
  • Burtonsville, MD
National Provider Identifier
1174962484
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA7178 Issued in DC
Practice address
3900 Greencastle Ridge Dr
Apt 301
Burtonsville, MD 20866-2118
Phone
(301) 364-8553
NPI assigned
Jun 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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 HHA7178 DC Primary

Addresses

Primary practice location

3900 Greencastle Ridge Dr
Apt 301
Burtonsville, MD 20866-2118

Mailing address

3900 Greencastle Ridge Dr
Apt 301
Burtonsville, MD 20866-2118
Phone (301) 364-8553

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
HHA7178DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1174962484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 GREENCASTLE RIDGE DR",
            "address_2": "APT 301",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208662118",
            "telephone_number": "301-364-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 GREENCASTLE RIDGE DR",
            "address_2": "APT 301",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208662118",
            "telephone_number": "301-364-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIBODU",
        "first_name": "FUMI",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA7178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burtonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.