Active NPI
Bertine Fang
- Home Health Aide
- Beltsville, MD
National Provider Identifier
1417470519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- HHA12904
- Practice address
- 11449 Cherry Hill Rd Apt 103
Beltsville, MD 20705-3646 - Phone
- (240) 360-3419
- Fax
- (240) 360-3419
- NPI assigned
- Jul 20, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | HHA12904 | DC | Primary |
Addresses
Primary practice location
11449 Cherry Hill Rd Apt 103
Beltsville, MD 20705-3646
Mailing address
11449 Cherry Hill Rd Apt 103
Beltsville, MD 20705-3646
Phone (240) 360-3419
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HHA12904 | Medicaid | DC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| HHA12904 | DC | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500508800000",
"number": "1417470519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11449 CHERRY HILL RD APT 103",
"city": "BELTSVILLE",
"state": "MD",
"postal_code": "207053646",
"telephone_number": "240-360-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11449 CHERRY HILL RD APT 103",
"city": "BELTSVILLE",
"state": "MD",
"postal_code": "207053646",
"telephone_number": "240-360-3419",
"fax_number": "240-360-3419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANG",
"first_name": "BERTINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-20",
"last_updated": "2017-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Home Health Aide",
"state": "DC",
"license": "HHA12904",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HHA12904",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beltsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.