Individual provider Active NPI

Ashenafi Desta Gonemo

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1508544347
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA200002911 Issued in DC
Practice address
1415 Tuckerman St NW
Washington, DC 20011-1081
Phone
(202) 910-5456
NPI assigned
Jul 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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 HHA200002911 DC Primary

Addresses

Primary practice location

1415 Tuckerman St NW
Washington, DC 20011-1081

Mailing address

1415 Tuckerman St NW
Washington, DC 20011-1081
Phone (202) 910-5456

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
HHA200002911DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1508544347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 TUCKERMAN ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111081",
            "telephone_number": "202-910-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TUCKERMAN ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111081",
            "telephone_number": "202-910-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONEMO",
        "first_name": "ASHENAFI",
        "middle_name": "DESTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA200002911",
            "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 Jul 11, 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.

Verify at the official NPI Registry.