Active NPI
Mohamed Komkanda Bangura, MA
- Community Health Worker
- Washington, DC
National Provider Identifier
1447945845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 702 15TH St NE
Washington, DC 20002-4508 - Phone
- (202) 847-3218
- NPI assigned
- Apr 11, 2023
- Last updated
- May 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | NU | ||
| Community Health Worker | 172V00000X | NU | Primary | |
| Community/Behavioral Health Agency | 251S00000X | NU |
Addresses
Primary practice location
702 15TH St NE
Washington, DC 20002-4508
Mailing address
702 15TH St NE
Washington, DC 20002-4508
Phone (202) 847-3218
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683849600000",
"number": "1447945845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 15TH ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200024508",
"telephone_number": "202-847-3218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 15TH ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200024508",
"telephone_number": "202-847-3218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGURA",
"first_name": "MOHAMED",
"middle_name": "KOMKANDA",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-11",
"last_updated": "2023-05-12",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NU",
"license": null,
"primary": false
}
],
"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 May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.