Individual provider Active NPI

Agnes Foncha Malung

  • Home Health Aide
  • Laurel, MD
National Provider Identifier
1316831761
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA20005051 Issued in DC
Practice address
12230 Apache Tears Cir
Laurel, MD 20708-2847
Phone
(301) 672-0061
NPI assigned
Jun 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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 HHA20005051 DC Primary

Addresses

Primary practice location

12230 Apache Tears Cir
Laurel, MD 20708-2847

Mailing address

12230 Apache Tears Cir
Laurel, MD 20708-2847
Phone (301) 672-0061

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
HHA20005051DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1316831761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12230 APACHE TEARS CIR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082847",
            "telephone_number": "301-672-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 APACHE TEARS CIR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082847",
            "telephone_number": "301-672-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALUNG",
        "first_name": "AGNES",
        "middle_name": "FONCHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA20005051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.