Individual provider Active NPI

Wazieh Elvis Kubong

  • Home Health Aide
  • Silver Spring, MD
National Provider Identifier
1235655192
Registry record updated Aug 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
3412 Hewitt Ave
Silver Spring, MD 20906-5408
Phone
(301) 804-8343
NPI assigned
Aug 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2017

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 Primary

Addresses

Primary practice location

3412 Hewitt Ave
Silver Spring, MD 20906-5408

Mailing address

3412 Hewitt Ave
Silver Spring, MD 20906-5408
Phone (301) 804-8343

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": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503360000000",
    "number": "1235655192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 HEWITT AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209065408",
            "telephone_number": "301-804-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 HEWITT AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209065408",
            "telephone_number": "301-804-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBONG",
        "first_name": "WAZIEH",
        "middle_name": "ELVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-22",
        "last_updated": "2017-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "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 Aug 22, 2017; 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.