Individual provider Active NPI

Serkalem Merra

  • Home Health Aide
  • Hyattsville, MD
National Provider Identifier
1366792822
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA4946 Issued in DC
Practice address
6475 New Hampshire Ave Ste 500a
Hyattsville, MD 20783-3295
Phone
(301) 560-1352
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 30753 DC
Licensed Vocational Nurse 164X00000X 3753 DC
Home Health Aide 374U00000X HHA4946 DC Primary

Addresses

Primary practice location

6475 New Hampshire Ave Ste 500a
Hyattsville, MD 20783-3295

Mailing address

6475 New Hampshire Ave Ste 500a
Hyattsville, MD 20783-3295
Phone (301) 560-1352

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
30753DCMDLicensed Vocational Nurse
3753DCMDLicensed Vocational Nurse
HHA4946DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1366792822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 NEW HAMPSHIRE AVE STE 500A",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207833295",
            "telephone_number": "301-560-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 NEW HAMPSHIRE AVE STE 500A",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207833295",
            "telephone_number": "301-560-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRA",
        "first_name": "SERKALEM",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "DC",
            "license": "30753",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "DC",
            "license": "3753",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA4946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.

Verify at the official NPI Registry.