Active NPI
Lateefat Omolara Fagbenro
- Home Health Aide
- Landover, MD
National Provider Identifier
1346624939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- HHA11333
- Practice address
- 3318 Dodge Park Rd Apt 101
Landover, MD 20785-2114 - Phone
- (240) 413-1823
- NPI assigned
- Jul 14, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NA00809491 | MD | |
| Home Health Aide | 374U00000X | HHA11333 | DC | Primary |
Addresses
Primary practice location
3318 Dodge Park Rd Apt 101
Landover, MD 20785-2114
Mailing address
3318 Dodge Park Rd Apt 101
Landover, MD 20785-2114
Phone (240) 413-1823
Other practice location 1
3211 75th Ave Apt 405
Landover, MD 20785-1932
Phone (240) 413-1823
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
| License | State | Type | Specialty |
|---|---|---|---|
| HHA11333 | DC | MD | Home Health Aide |
| NA00809491 | MD | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520985600000",
"number": "1346624939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3318 DODGE PARK RD APT 101",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207852114",
"telephone_number": "240-413-1823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3318 DODGE PARK RD APT 101",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207852114",
"telephone_number": "240-413-1823"
}
],
"practiceLocations": [
{
"address_1": "3211 75th Ave Apt 405",
"address_purpose": "LOCATION",
"city": "Landover",
"state": "MD",
"postal_code": "207851932",
"country_code": "US",
"telephone_number": "240-413-1823",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAGBENRO",
"first_name": "LATEEFAT",
"middle_name": "OMOLARA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-14",
"last_updated": "2018-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MD",
"license": "NA00809491",
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "DC",
"license": "HHA11333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Landover, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.