Caleb Forkwa Fomben

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HHA6571 Issued in WA

Practice address

6511 Woodstream Dr
MD 20706
Lanham, MD 20706-2119

Phone

(240) 705-4053

NPI assigned

May 9, 2013

Last updated

May 9, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1376988832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6511 WOODSTREAM DR",
            "address_2": "MD 20706",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062119",
            "telephone_number": "240-705-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6511 WOODSTREAM DR",
            "address_2": "MD 20706",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062119",
            "telephone_number": "240-705-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMBEN",
        "first_name": "CALEB",
        "middle_name": "FORKWA",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-09",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": "HHA6571",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "WA",
            "license": "HHA6571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Achianu Divine Folefac
• Ashley Foley
• Bintu Fomba
• Mervyn Fombe-Abiko
• Elie Tebah Fombele
• Divine Achosei Fon
• George Tekwe Fon
• Hosea M Fon
• Irene Njweng Fon
• Joseph Tekea Fon

• Home Health Agency in Lanham, MD
• Providers in Lanham, MD by specialty
• Home Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.