Active NPI
Ivy Tifuh Mbah
- Home Health Aide
- Silver Spring, MD
National Provider Identifier
1205302908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- HHA14074
- Practice address
- 1515 November Cir Apt 201
Silver Spring, MD 20904-6947 - Phone
- (240) 641-3330
- NPI assigned
- Oct 19, 2018
- Sex
- Female
- 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 | HHA14074 | DC | Primary |
Addresses
Primary practice location
1515 November Cir Apt 201
Silver Spring, MD 20904-6947
Mailing address
1515 November Cir Apt 201
Silver Spring, MD 20904-6947
Phone (240) 641-3330
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
| License | State | Type | Specialty |
|---|---|---|---|
| HHA14074 | DC | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539907200000",
"number": "1205302908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 NOVEMBER CIR APT 201",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209046947",
"telephone_number": "240-641-3330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 NOVEMBER CIR APT 201",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209046947",
"telephone_number": "240-641-3330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MBAH",
"first_name": "IVY",
"middle_name": "TIFUH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-19",
"last_updated": "2018-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "DC",
"license": "HHA14074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.