Individual provider Active NPI

Aza Nedhari, CPM, LGPC

  • Midwife
  • College Park, MD
National Provider Identifier
1578892758
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
DEM00024 Issued in MD
Practice address
3500 Duke St
College Park, MD 20740-4016
Phone
(202) 746-7801
Fax
(202) 601-0485
NPI assigned
Dec 16, 2009
Last updated
May 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X DEM00024 MD Primary
Health EducatorGroup: 193400000X SINGLE SPECIALTY GROUP 174H00000X

Addresses

Primary practice location

3500 Duke St
College Park, MD 20740-4016

Mailing address

3500 Duke St
College Park, MD 20740-4016
Phone (202) 746-7801

Other practice location 1

4315 Sheriff Rd NE
Washington, DC 20019-3739
Phone (202) 248-3434

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
DEM00024MDMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Mamatoto Village Inc Health Educator CurrentSince Jun 30, 2024 Accepting new patients
Blue Sage Midwifery Midwife CurrentSince Mar 26, 2023 Accepting new patients

Locations

4315 Sheriff Rd NE
Washington, DC 20019
Phone (202) 248-3434

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1578892758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DUKE ST",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207404016",
            "telephone_number": "202-746-7801",
            "fax_number": "202-601-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 DUKE ST",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207404016",
            "telephone_number": "202-746-7801",
            "fax_number": "202-601-0485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4315 Sheriff Rd NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200193739",
            "country_code": "US",
            "telephone_number": "202-248-3434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEDHARI",
        "first_name": "AZA",
        "name_prefix": "Ms.",
        "credential": "CPM, LGPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-16",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "MD",
            "license": "DEM00024",
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.