Individual provider Active NPI

Fanos Tekleab

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1417424516
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA14985 Issued in DC
Practice address
2512 24TH St NE
Washington, DC 20018-2126
Phone
(202) 832-8340
Fax
(202) 832-8341
NPI assigned
Oct 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN1008614 DC
Home Health Aide 374U00000X
Home Health Aide 374U00000X HHA14985 DC Primary

Addresses

Primary practice location

2512 24TH St NE
Washington, DC 20018-2126

Mailing address

5746 Colorado Ave NW
Washington, DC 20011-7850
Phone (202) 459-7539

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
LPN1008614DCMDLicensed Practical Nurse
HHA14985DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1417424516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5746 COLORADO AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200117850",
            "telephone_number": "202-459-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 24TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200182126",
            "telephone_number": "202-832-8340",
            "fax_number": "202-832-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLEAB",
        "first_name": "FANOS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-26",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DC",
            "license": "LPN1008614",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA14985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.