Benedeth Uju Moh

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

031 R 0040 Issued in GA

Practice address

9411 S Main St Ste D
Jonesboro, GA 30236-8705

Phone

(770) 477-4755

Fax

(770) 477-4758

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shirley Ogo Gates Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arkangels Homecare Services

  • Durable Medical Equipment & Medical Supplies
  • Jonesboro, GA
  • NPI 1316195712
  NPD
• Arkangels Homecare Services, Inc.

  • Home Health Agency
  • Jonesboro, GA
  • NPI 1043482987
  NPD

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1386662617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 S MAIN ST STE D",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302368705",
            "telephone_number": "770-477-4755",
            "fax_number": "770-477-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 S MAIN ST STE D",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302368705",
            "telephone_number": "770-477-4755",
            "fax_number": "770-477-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOH",
        "first_name": "BENEDETH",
        "middle_name": "UJU",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": "031 R 0040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "457729570D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "GATES",
            "middle_name": "OGO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wakako Minamotowood, MA, S/T
• Mindset Development Center
• Chiketta Mitchell, RN, AGNP
• Sharon C Mitchell, LDO
• Tarissa Mitchell, M.D.
• Sarfraz Ahmad Mohamed, MD
• Mecca Mohammed
• Althea Montgomery
• Tiara Moore-James
• Chaska Lashawn Moore, PA-C

• Home Health Aide in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Home Health Aide in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.