Kenneth Nyasa Bambot

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

4920 Niagara Rd
Ste 318
College Park, MD 20740-1110

Phone

(301) 982-6477

Fax

(301) 982-6488

NPI assigned

Apr 2, 2013

Sex

Male

Sole proprietor

Yes

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

• Ultimate Goal Home Care Agency Inc

  • Home Health Agency
  • College Park, MD
  • NPI 1437441896
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 2, 2013.

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1619210218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 NIAGARA RD",
            "address_2": "STE 318",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401110",
            "telephone_number": "301-982-6477",
            "fax_number": "301-982-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 NIAGARA RD",
            "address_2": "STE 318",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401110",
            "telephone_number": "301-982-6477",
            "fax_number": "301-982-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBOT",
        "first_name": "KENNETH",
        "middle_name": "NYASA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Tifuh Awasum
• Oyebola Hammed Babarinde Jr.
• Zainab Kamara Baity
• Baltimore Ave. Dental
• Kori Baltimore
• Sidratu Bangura
• Angela Marie Banks-Smith, RMP
• Alpha Teresa Banks, M.D.
• Kiaisha Barber, LCSW-C
• Beidi A Bare

• All providers in College Park, MD
• Home Health Aide in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.