Active NPI
Odette Mokuba
- Nurse's Aide
- Takoma Park, MD
National Provider Identifier
1467082354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 1401191138
- Practice address
- 709 Hudson Ave Apt 3
Takoma Park, MD 20912-6817 - Phone
- (240) 486-7333
- NPI assigned
- Jan 20, 2020
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | VA | ||
| Mental Health Counselor | 101YM0800X | |||
| Pastoral Counselor | 101YP1600X | |||
| Nurse's Aide | 376K00000X | VA | ||
| Nurse's Aide | 376K00000X | 1401191138 | VA | Primary |
Addresses
Primary practice location
709 Hudson Ave Apt 3
Takoma Park, MD 20912-6817
Mailing address
709 Hudson Ave Apt 3
Takoma Park, MD 20912-6817
Phone (240) 486-7333
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | omokuba@ymail.com | Direct | |
| Direct Messaging Address | omokuba@ymail.com | Other | |
| Direct Messaging Address | omokuba@ymail.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | omokuba@ymail.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 1401191138 | VA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579478400000",
"number": "1467082354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 HUDSON AVE APT 3",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209126817",
"telephone_number": "240-486-7333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 HUDSON AVE APT 3",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209126817",
"telephone_number": "240-486-7333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOKUBA",
"first_name": "ODETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-20",
"last_updated": "2020-01-20",
"certification_date": "2020-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "VA",
"license": null,
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "VA",
"license": "1401191138",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "omokuba@ymail.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "709 Hudson Ave Apt 3",
"city": "Takoma Park",
"state": "MD",
"country_code": "US",
"postal_code": "209126817",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "omokuba@ymail.com",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "omokuba@ymail.com",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "709 Hudson Ave Apt 3",
"city": "Takoma Park",
"state": "MD",
"country_code": "US",
"postal_code": "209126817",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "omokuba@ymail.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "709 Hudson Ave Apt 3",
"city": "Takoma Park",
"state": "MD",
"country_code": "US",
"postal_code": "209126817",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "omokuba@ymail.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "709 Hudson Ave Apt 3",
"city": "Takoma Park",
"state": "MD",
"country_code": "US",
"postal_code": "209126817",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Takoma Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.