Individual provider Active NPI

Johnpaul Asaba Achendungbong II

  • Clinical Social Worker
  • Bowie, MD
National Provider Identifier
1285341842
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1506 Fairlakes PL
Bowie, MD 20721-3102
Phone
(240) 938-3394
NPI assigned
Nov 3, 2022
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

1506 Fairlakes PL
Bowie, MD 20721-3102

Mailing address

1506 Fairlakes PL
Bowie, MD 20721-3102
Phone (240) 938-3394

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": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1285341842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 FAIRLAKES PL",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207213102",
            "telephone_number": "240-938-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 FAIRLAKES PL",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207213102",
            "telephone_number": "240-938-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACHENDUNGBONG",
        "first_name": "JOHNPAUL",
        "middle_name": "ASABA",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.