Active NPI
Severin Njeck Tebo Sr.
- Home Health Aide
- Silver Spring, MD
National Provider Identifier
1457085383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 200001966
- Practice address
- 11329 Columbia Pike Apt C6
Silver Spring, MD 20904-2505 - Phone
- (202) 316-5676
- NPI assigned
- Jul 15, 2022
- Sex
- Male
- Sole proprietor
- No
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 | 200001966 | WA | Primary |
Addresses
Primary practice location
11329 Columbia Pike Apt C6
Silver Spring, MD 20904-2505
Mailing address
11329 Columbia Pike
Apt C6
Silver Spring, MD 20904
Phone (202) 316-5676
Other practice location 1
11329 columbia pike
apt c6
Silver Spring, MD 20904
Phone (202) 316-5676
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 |
|---|---|---|---|
| 200001966 | WA | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1457085383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11329 COLUMBIA PIKE",
"address_2": "APT C6",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "20904",
"telephone_number": "202-316-5676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11329 COLUMBIA PIKE APT C6",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209042505",
"telephone_number": "202-316-5676"
}
],
"practiceLocations": [
{
"address_1": "11329 columbia pike",
"address_2": "apt c6",
"address_purpose": "LOCATION",
"city": "Silver Spring",
"state": "MD",
"postal_code": "20904",
"country_code": "US",
"telephone_number": "202-316-5676",
"fax_number": "202-316-5676",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TEBO",
"first_name": "SEVERIN",
"middle_name": "NJECK",
"name_suffix": "Sr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-15",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "WA",
"license": "200001966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.