Individual provider Active NPI

Ulrich Brice Mougang Komkep

  • Home Health Aide
  • Silver Spring, MD
National Provider Identifier
1275034019
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA13440 Issued in DC
Practice address
11408 December Way
Silver Spring, MD 20904-3624
Phone
(202) 704-2299
NPI assigned
Feb 27, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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 HHA13440 DC Primary

Addresses

Primary practice location

11408 December Way
Silver Spring, MD 20904-3624

Mailing address

11408 December Way
Silver Spring, MD 20904-3624
Phone (202) 704-2299

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
HHA13440DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1275034019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11408 DECEMBER WAY",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209043624",
            "telephone_number": "202-704-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11408 DECEMBER WAY",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209043624",
            "telephone_number": "202-704-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUGANG KOMKEP",
        "first_name": "ULRICH BRICE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA13440",
            "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 Feb 27, 2018; 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.