Active NPI
Alimie Koroma, LPN
- Licensed Practical Nurse
- Washington, DC
National Provider Identifier
1265040455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP1005745
- Practice address
- 6120 Kansas Ave NW
Washington, DC 20011 - Phone
- (202) 829-1719
- Fax
- (202) 722-4719
- NPI assigned
- Jul 14, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP1005745 | DC | Primary |
Addresses
Primary practice location
6120 Kansas Ave NW
Washington, DC 20011
Mailing address
11 Appledowre CT
Germantown, MD 20876-5513
Phone (301) 537-2883
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 901969194 | Other | CARE FIRST BLUECHOICE |
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 |
|---|---|---|---|
| LP1005745 | DC | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594684800000",
"number": "1265040455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 APPLEDOWRE CT",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208765513",
"telephone_number": "301-537-2883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6120 KANSAS AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20011",
"telephone_number": "202-829-1719",
"fax_number": "202-722-4719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOROMA",
"first_name": "ALIMIE",
"name_prefix": "Mr.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-14",
"last_updated": "2020-07-14",
"certification_date": "2020-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "DC",
"license": "LP1005745",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST BLUECHOICE",
"identifier": "901969194",
"state": null
}
],
"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 Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.