Individual provider Active NPI

Vanessa Floricette Mavoungou Misere

  • Home Health Aide
  • Lanham, MD
National Provider Identifier
1609302595
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA 12742 Issued in DC
Practice address
6880 Riverdale Rd Apt 843
Lanham, MD 20706-1068
Phone
(240) 714-7600
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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 HHA 12742 DC Primary

Addresses

Primary practice location

6880 Riverdale Rd Apt 843
Lanham, MD 20706-1068

Mailing address

6880 Riverdale Rd Apt 843
Lanham, MD 20706-1068

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
HHA 12742DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1609302595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6880 RIVERDALE RD APT 843",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207061068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6880 RIVERDALE RD APT 843",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207061068",
            "telephone_number": "240-714-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVOUNGOU MISERE",
        "first_name": "VANESSA FLORICETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA 12742",
            "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 May 11, 2017; 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.