Claudette Emmeline Demetrius

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

991558 Issued in MD

Practice address

16220 Fredrick Ave
#12
Geithersberg, MD 20877

Phone

(301) 208-0775

NPI assigned

Dec 15, 2006

Last updated

Feb 27, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1497817373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13529 GEORGIA AVE",
            "address_2": "APARTMENT 203",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "20906",
            "telephone_number": "301-946-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16220 FREDRICK AVE",
            "address_2": "#12",
            "city": "GEITHERSBERG",
            "state": "MD",
            "postal_code": "20877",
            "telephone_number": "301-208-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRIUS",
        "first_name": "CLAUDETTE",
        "middle_name": "EMMELINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MD",
            "license": "991558",
            "primary": true
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "MD",
            "license": "A00015852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714564100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED GERIATRIC NURSE",
            "identifier": "A00015852",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "4387007-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.