Individual provider Active NPI

Theophilus Chidi Amaefule

  • Home Health Aide
  • Derwood, MD
National Provider Identifier
1184276404
Registry record updated Nov 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA14510 Issued in DC
Practice address
7770 Epsilon Dr
Derwood, MD 20855-2555
Phone
(240) 722-9967
NPI assigned
Jul 16, 2019
Last updated
Nov 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2024

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 HHA14510 DC Primary

Addresses

Primary practice location

7770 Epsilon Dr
Derwood, MD 20855-2555

Mailing address

7770 Epsilon Dr
Derwood, MD 20855-2555

Other practice location 1

7770 Epsilon Dr
Derwood, MD 20855-2555
Phone (240) 722-9967

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
HHA14510DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1184276404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7770 EPSILON DR",
            "city": "DERWOOD",
            "state": "MD",
            "postal_code": "208552555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7770 EPSILON DR",
            "city": "DERWOOD",
            "state": "MD",
            "postal_code": "208552555",
            "telephone_number": "240-722-9967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7770 Epsilon Dr",
            "address_purpose": "LOCATION",
            "city": "Derwood",
            "state": "MD",
            "postal_code": "208552555",
            "country_code": "US",
            "telephone_number": "240-722-9967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMAEFULE",
        "first_name": "THEOPHILUS",
        "middle_name": "CHIDI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA14510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derwood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; 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.