Individual provider Active NPI

Kdusan Welelibanos Hadgu

  • Home Health Aide
  • Columbia, MD
National Provider Identifier
1346920303
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
AOO205969 Issued in DC
Practice address
6138 Quiet Times
Columbia, MD 21045-7427
Phone
(202) 751-0571
NPI assigned
Jul 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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 AOO205969 DC Primary

Addresses

Primary practice location

6138 Quiet Times
Columbia, MD 21045-7427

Mailing address

6138 Quiet Times
Columbia, MD 21045-7427
Phone (202) 751-0571

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
AOO205969DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1346920303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6138 QUIET TIMES",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210457427",
            "telephone_number": "202-751-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6138 QUIET TIMES",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210457427",
            "telephone_number": "202-751-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADGU",
        "first_name": "KDUSAN",
        "middle_name": "WELELIBANOS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "AOO205969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.