Individual provider Active NPI

Fnu Fonta Liembo Fonta

  • Home Health Aide
  • Lanham, MD
National Provider Identifier
1639659121
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA13733 Issued in DC
Practice address
6603 Manton Way
Lanham, MD 20706-2490
Phone
(703) 944-2201
NPI assigned
Aug 15, 2018
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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 HHA13733 DC Primary

Addresses

Primary practice location

6603 Manton Way
Lanham, MD 20706-2490

Mailing address

6603 Manton Way
Lanham, MD 20706-2490
Phone (703) 944-2201

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
HHA13733DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1639659121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6603 MANTON WAY",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062490",
            "telephone_number": "703-944-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6603 MANTON WAY",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062490",
            "telephone_number": "703-944-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTA LIEMBO FONTA",
        "first_name": "FNU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA13733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.