Individual provider Active NPI

Ryant Yitembin

  • Community Health Worker
  • Washington, DC
National Provider Identifier
1205682069
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
2918 Minnesota Ave SE
Washington, DC 20019-1127
Phone
(301) 433-3005
NPI assigned
Apr 24, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X Primary

Addresses

Primary practice location

2918 Minnesota Ave SE
Washington, DC 20019-1127

Mailing address

13101 Livingstone Endeavor Dr
Bowie, MD 20720-3396
Phone (771) 201-4665

Other practice location 1

2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Phone (202) 894-6811

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": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1205682069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13101 LIVINGSTONE ENDEAVOR DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203396",
            "telephone_number": "771-201-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 MINNESOTA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200191127",
            "telephone_number": "301-433-3005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2811 Pennsylvania Ave SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200203865",
            "country_code": "US",
            "telephone_number": "202-894-6811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YITEMBIN",
        "first_name": "RYANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-24",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.