Active NPI
Nelson Tebo
- Home Health Aide
- Glenn Dale, MD
National Provider Identifier
1194421032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 11302 Springpark CT
Glenn Dale, MD 20769-9611 - Phone
- (240) 467-6589
- NPI assigned
- Feb 2, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Primary |
Addresses
Primary practice location
11302 Springpark CT
Glenn Dale, MD 20769-9611
Mailing address
11302 Springpark CT
Glenn Dale, MD 20769-9611
Phone (240) 467-6589
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1194421032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11302 SPRINGPARK CT",
"city": "GLENN DALE",
"state": "MD",
"postal_code": "207699611",
"telephone_number": "240-467-6589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11302 SPRINGPARK CT",
"city": "GLENN DALE",
"state": "MD",
"postal_code": "207699611",
"telephone_number": "240-467-6589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEBO",
"first_name": "NELSON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-02",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenn Dale, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.