Individual provider Active NPI

Rene Wuvalla

  • Home Health Aide
  • Upper Marlboro, MD
National Provider Identifier
1629653324
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
212 Settlers Way
Upper Marlboro, MD 20774-5770
Phone
(301) 693-8876
NPI assigned
Mar 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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 DC Primary

Addresses

Primary practice location

212 Settlers Way
Upper Marlboro, MD 20774-5770

Mailing address

212 Settlers Way
Upper Marlboro, MD 20774-5770
Phone (301) 693-8876

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

NPI Registry JSON

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1629653324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 SETTLERS WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745770",
            "telephone_number": "301-693-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 SETTLERS WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745770",
            "telephone_number": "301-693-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUVALLA",
        "first_name": "RENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-14",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.