Massamesso David Agolmiassou
Individual provider Active NPI Adult Companion · Omaha, NE
NPI 1497546683 · NPPES record last updated May 15, 2025
Key facts
- NPI
- 1497546683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Companion 372600000X
- Practice address
- 2121 N 120TH St
Omaha, NE 68164-3477 - Phone
- (402) 840-7168
- NPI assigned
- May 15, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | Yes |
Addresses
Primary practice location
2121 N 120TH St
Omaha, NE 68164-3477
Mailing address
2121 N 120TH St
Omaha, NE 68164-3477
Phone (402) 840-7168
Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.