Individual provider Active NPI

Kokobie Kersima

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1336667468
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA13007 Issued in DC
Practice address
1820 Jefferson PL NW Ste 101
Washington, DC 20036-2505
Phone
(202) 749-2136
NPI assigned
Sep 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 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 HHA13007 DC Primary

Addresses

Primary practice location

1820 Jefferson PL NW Ste 101
Washington, DC 20036-2505

Mailing address

104 Fort Dr NE Apt 4
Washington, DC 20011-7422

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
HHA13007DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1336667468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FORT DR NE APT 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200117422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 JEFFERSON PL NW STE 101",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200362505",
            "telephone_number": "202-749-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSIMA",
        "first_name": "KOKOBIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA13007",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 19, 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.