Individual provider Active NPI

Monique Enambong Emambu

  • Home Health Aide
  • Hyattsville, MD
National Provider Identifier
1629585542
Registry record updated Dec 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA13366 Issued in DC
Practice address
3406 54TH Ave Apt 2
Hyattsville, MD 20784-1002
Phone
(240) 714-7085
NPI assigned
Dec 30, 2017
Last updated
Dec 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 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 HHA13366 DC Primary

Addresses

Primary practice location

3406 54TH Ave Apt 2
Hyattsville, MD 20784-1002

Mailing address

3406 54TH Ave Apt 2
Hyattsville, MD 20784-1002
Phone (240) 714-7085

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
HHA13366DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1514592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514592000000",
    "number": "1629585542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 54TH AVE APT 2",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207841002",
            "telephone_number": "240-714-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 54TH AVE APT 2",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207841002",
            "telephone_number": "240-714-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMAMBU",
        "first_name": "MONIQUE",
        "middle_name": "ENAMBONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-30",
        "last_updated": "2017-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA13366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.