Individual provider Active NPI

Benedicta Egbuanran

  • Licensed Practical Nurse
  • Washington, DC
National Provider Identifier
1235916776
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN200002583 Issued in DC
Practice address
2600 Bryan PL SE
Washington, DC 20020-4417
Phone
(240) 423-8530
NPI assigned
Sep 8, 2023
Last updated
Sep 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN200002583 DC Primary

Addresses

Primary practice location

2600 Bryan PL SE
Washington, DC 20020-4417

Mailing address

5722 Glen Ave
Lanham, MD 20706-4730

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

LicenseStateTypeSpecialty
LPN200002583DCMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1235916776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5722 GLEN AVE",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207064730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 BRYAN PL SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200204417",
            "telephone_number": "240-423-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBUANRAN",
        "first_name": "BENEDICTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DC",
            "license": "LPN200002583",
            "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 Sep 12, 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.

Verify at the official NPI Registry.