Individual provider Active NPI

Bannaz Hadji Shamo

  • Home Health Aide
  • Raymond, NE
National Provider Identifier
1235024019
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
11401 NW 70TH St
Raymond, NE 68428-4250
Phone
(402) 785-4129
NPI assigned
Jun 11, 2025
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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 NU Primary

Addresses

Primary practice location

11401 NW 70TH St
Raymond, NE 68428-4250

Mailing address

9018 Fort St
Omaha, NE 68134-1749
Phone (402) 808-0899

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": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1235024019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9018 FORT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681341749",
            "telephone_number": "402-808-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 NW 70TH ST",
            "city": "RAYMOND",
            "state": "NE",
            "postal_code": "684284250",
            "telephone_number": "402-785-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMO",
        "first_name": "BANNAZ",
        "middle_name": "HADJI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymond, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.