Individual provider Active NPI

Fnu Ali Mallam Baba

  • Home Health Aide
  • Laurel, MD
National Provider Identifier
1629824347
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
14108 Bramble CT
Laurel, MD 20708-1214
Phone
(763) 388-5735
NPI assigned
Apr 24, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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 Primary

Addresses

Primary practice location

14108 Bramble CT
Laurel, MD 20708-1214

Mailing address

14108 Bramble CT
Laurel, MD 20708-1214

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": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1629824347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14108 BRAMBLE CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14108 BRAMBLE CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081214",
            "telephone_number": "763-388-5735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI MALLAM BABA",
        "first_name": "FNU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.