Individual provider Active NPI

Annick Payong Chima Hebou, MD

  • Internal Medicine Physician
  • Waldorf, MD
National Provider Identifier
1629235759
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD036989 Issued in DC
Practice address
3500 Old Washington Rd Ste 102
Waldorf, MD 20602-3205
Phone
(240) 514-2323
Fax
(240) 514-8851
NPI assigned
May 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0092835 MD
Internal Medicine Physician 207R00000X MD036989 DC Primary

Addresses

Primary practice location

3500 Old Washington Rd Ste 102
Waldorf, MD 20602-3205

Mailing address

3500 Old Washington Rd Ste 102
Waldorf, MD 20602-3205
Phone (240) 514-2323

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahebou@ufirsthealthonline.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141112001113 DC Practitioner - Internal Medicine 5092937839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD036989DCMDInternal Medicine Physician
D0092835MDMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: annick.hebou@436406953705476.direct.elationemr.com

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1629235759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 OLD WASHINGTON RD STE 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023205",
            "telephone_number": "240-514-2323",
            "fax_number": "240-514-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OLD WASHINGTON RD STE 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023205",
            "telephone_number": "240-514-2323",
            "fax_number": "240-514-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBOU",
        "first_name": "ANNICK",
        "middle_name": "PAYONG CHIMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0092835",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD036989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahebou@ufirsthealthonline.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3500 Old Washington Rd Ste 102",
            "city": "Waldorf",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206023205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.