Individual provider Active NPI

Divine Kimah I

  • Home Health Aide
  • New Carrollton, MD
National Provider Identifier
1508274051
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA10240 Issued in DC
Practice address
7837 Riverdale Rd
Apt 302
New Carrollton, MD 20784-4020
Phone
(240) 264-9850
NPI assigned
Jul 29, 2014
Last updated
Jul 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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 HHA10240 DC Primary

Addresses

Primary practice location

7837 Riverdale Rd
Apt 302
New Carrollton, MD 20784-4020

Mailing address

7837 Riverdale Rd
Apt 302
New Carrollton, MD 20784-4020
Phone (240) 264-9850

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
HHA10240DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1508274051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7837 RIVERDALE RD",
            "address_2": "APT 302",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207844020",
            "telephone_number": "240-264-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7837 RIVERDALE RD",
            "address_2": "APT 302",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207844020",
            "telephone_number": "240-264-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMAH",
        "first_name": "DIVINE",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA10240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Carrollton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.