Individual provider Active NPI

Divine Folefac Zisuh

  • Home Health Aide
  • Lanham, MD
National Provider Identifier
1548522972
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
Z-200-143-258-871 Issued in MD
Practice address
9893 Good Luck Rd
Apt 7
Lanham, MD 20706-3220
Phone
(202) 378-0041
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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 Z-200-143-258-871 MD Primary

Addresses

Primary practice location

9893 Good Luck Rd
Apt 7
Lanham, MD 20706-3220

Mailing address

9893 Good Luck Rd
Apt 7
Lanham, MD 20706-3220
Phone (202) 378-0041

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
Z-200-143-258-871MDMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1548522972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9893 GOOD LUCK RD",
            "address_2": "APT 7",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063220",
            "telephone_number": "202-378-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9893 GOOD LUCK RD",
            "address_2": "APT 7",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063220",
            "telephone_number": "202-378-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZISUH",
        "first_name": "DIVINE",
        "middle_name": "FOLEFAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MD",
            "license": "Z-200-143-258-871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.