Individual provider Active NPI

Ndimukum Tankeh Bertha

  • Home Health Aide
  • Bowie, MD
National Provider Identifier
1326623992
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
11208 Westport Dr
Bowie, MD 20720-3410
Phone
(240) 302-5158
NPI assigned
Mar 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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 Primary

Addresses

Primary practice location

11208 Westport Dr
Bowie, MD 20720-3410

Mailing address

11208 Westport Dr
Bowie, MD 20720-3410
Phone (240) 302-5158

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": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1326623992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11208 WESTPORT DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203410",
            "telephone_number": "240-302-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11208 WESTPORT DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203410",
            "telephone_number": "240-302-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKEH BERTHA",
        "first_name": "NDIMUKUM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "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 Apr 8, 2021; 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.