Individual provider Active NPI

Jeannine Mateubeu Takouam

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1508231259
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA11669 Issued in DC
Practice address
1707 L St NW Ste 900
Washington, DC 20036-4208
Phone
(202) 829-1111
Fax
(202) 829-9192
NPI assigned
Dec 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA11669 DC Primary

Addresses

Primary practice location

1707 L St NW Ste 900
Washington, DC 20036-4208

Mailing address

4107 53Rd Ave Apt 2
Bladensburg, MD 20710-1452
Phone (202) 749-1110

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

LicenseStateTypeSpecialty
HHA11669DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1508231259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 53RD AVE APT 2",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207101452",
            "telephone_number": "202-749-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 L ST NW STE 900",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200364208",
            "telephone_number": "202-829-1111",
            "fax_number": "202-829-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEUBEU TAKOUAM",
        "first_name": "JEANNINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA11669",
            "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 Apr 3, 2018; 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.