Active NPI
Express Home & Renal Healthcare, LLC.
- Pediatric Skilled Nursing Facility
- Kensington, MD
National Provider Identifier
1184309197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Skilled Nursing Facility
- Legal business name
- EXPRESS HOME & RENAL HEALTHCARE, LLC.
- Practice address
- 10400 Connecticut Ave Ste 602
Kensington, MD 20895-3909 - Phone
- (301) 825-5900
- Fax
- (301) 825-5888
- NPI assigned
- Jun 19, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Solomon M M Fon, CPA
- Title
- Ceo/Administrator
- Phone
- (301) 704-2667
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Skilled Nursing Facility | 3140N1450X | Primary |
Addresses
Primary practice location
10400 Connecticut Ave Ste 602
Kensington, MD 20895-3909
Mailing address
10400 Connecticut Ave Ste 602
Kensington, MD 20895-3909
Phone (301) 825-5900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5587216200 | Medicaid | MD |
Other names 1
- EXPRESS HOME & RENAL HEALTHCARE, LLC.
National Provider Directory
National Provider Directory- Tax ID family
- Express Home Renal Healthcare LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Kensington, MD
- NPI 1518721042
-
- Home Health Agency
- Kensington, MD
- NPI 1821755968
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Registered Nurse
- Silver Spring, MD
- NPI 1275115420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687132800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687132800000",
"number": "1184309197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10400 CONNECTICUT AVE STE 602",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208953909",
"telephone_number": "301-825-5900",
"fax_number": "301-825-5888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 CONNECTICUT AVE STE 602",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208953909",
"telephone_number": "301-825-5900",
"fax_number": "301-825-5888"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXPRESS HOME & RENAL HEALTHCARE, LLC.",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-19",
"last_updated": "2023-06-19",
"certification_date": "2023-06-14",
"status": "A",
"authorized_official_last_name": "M FON",
"authorized_official_first_name": "SOLOMON",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CEO/ADMINISTRATOR",
"authorized_official_telephone_number": "301-704-2667",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CPA"
},
"taxonomies": [
{
"code": "3140N1450X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5587216200",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "EXPRESS HOME & RENAL HEALTHCARE, LLC.",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Kensington, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.