Individual provider Active NPI

Adeloye Gbadegesin, HHA

  • Home Health Aide
  • Landover, MD
National Provider Identifier
1417217001
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA0719 Issued in DC
Practice address
1767 Dutch Village Dr
Landover, MD 20785-4169
Phone
(202) 545-0935
NPI assigned
May 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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 HHA0719 DC Primary

Addresses

Primary practice location

1767 Dutch Village Dr
Landover, MD 20785-4169

Mailing address

1767 Dutch Village Dr
Landover, MD 20785-4169
Phone (202) 545-0935

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
HHA0719DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1417217001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1767 DUTCH VILLAGE DR",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207854169",
            "telephone_number": "202-545-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 DUTCH VILLAGE DR",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207854169",
            "telephone_number": "202-545-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GBADEGESIN",
        "first_name": "ADELOYE",
        "credential": "HHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA0719",
            "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 Feb 3, 2022; 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.