Active NPI
Valery A Mangoh
- Home Health Aide
- Bladensburg, MD
National Provider Identifier
1679189708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 5012 57TH Ave
Bladensburg, MD 20710-1617 - Phone
- (240) 917-8767
- NPI assigned
- Sep 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Primary |
Addresses
Primary practice location
5012 57TH Ave
Bladensburg, MD 20710-1617
Mailing address
5012 57TH Ave
Bladensburg, MD 20710-1617
Phone (240) 917-8767
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A00174434 | Medicaid | MD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | abahomehealth.com |
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": "1600819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1679189708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5012 57TH AVE",
"city": "BLADENSBURG",
"state": "MD",
"postal_code": "207101617",
"telephone_number": "240-917-8767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5012 57TH AVE",
"city": "BLADENSBURG",
"state": "MD",
"postal_code": "207101617",
"telephone_number": "240-917-8767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGOH",
"first_name": "VALERY",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-23",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "A00174434",
"state": "MD"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "abahomehealth.com",
"affiliation": "N",
"address_1": "5012 57th Ave",
"city": "Bladensburg",
"state": "MD",
"country_code": "US",
"postal_code": "207101617",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bladensburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.