Active NPI
Dominic Nkongho
- Case Manager/Care Coordinator
- Washington, DC
National Provider Identifier
1497459762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 2811 Pennsylvania Ave SE
Washington, DC 20020-3865 - Phone
- (202) 894-6811
- NPI assigned
- Mar 29, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | |||
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Mailing address
109 Waldon Rd Apt E
Abingdon, MD 21009-2125
Phone (410) 805-6619
Other practice location 1
3417 18th St NE
Washington, DC 20018-2721
Phone (202) 629-2917
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradley & Associates, LLC | Current | Accepting new patients | |
| Bradley & Associates, LLC | Current | Accepting new patients |
Locations
3417 18th St NE
Washington, DC 20018
Phone (202) 629-2917
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Washington, DC
- NPI 1679046353
-
- Case Management Agency
- Washington, DC
- NPI 1861128332
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692230400000",
"number": "1497459762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 WALDON RD APT E",
"city": "ABINGDON",
"state": "MD",
"postal_code": "210092125",
"telephone_number": "410-805-6619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2811 PENNSYLVANIA AVE SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200203865",
"telephone_number": "202-894-6811"
}
],
"practiceLocations": [
{
"address_1": "3417 18th St NE",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200182721",
"country_code": "US",
"telephone_number": "202-629-2917",
"fax_number": "202-629-2797",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NKONGHO",
"first_name": "DOMINIC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-29",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"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 Aug 17, 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.