Individual provider Active NPI

Raymond Jonkam

  • Home Health Aide
  • Hyattsville, MD
National Provider Identifier
1689048266
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA11654 Issued in DC
Practice address
5225 Kenilworth Ave
Hyattsville, MD 20781-2850
Phone
(757) 387-2677
NPI assigned
Nov 19, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 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 HHA11654 DC Primary

Addresses

Primary practice location

5225 Kenilworth Ave
Hyattsville, MD 20781-2850

Mailing address

5225 Kenilworth Ave
Hyattsville, MD 20781-2850
Phone (757) 387-2677

Other practice location 1

46860 Hilton Dr Apt 1131
Lexington Park, MD 20653-3730
Phone (757) 387-2677

Other identifiers 1

IdentifierTypeStateIssuer
HHA11654OtherDCHOME HEALTH AIDE

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
HHA11654DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1689048266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 KENILWORTH AVE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207812850",
            "telephone_number": "757-387-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 KENILWORTH AVE",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207812850",
            "telephone_number": "757-387-2677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46860 Hilton Dr Apt 1131",
            "address_purpose": "LOCATION",
            "city": "Lexington Park",
            "state": "MD",
            "postal_code": "206533730",
            "country_code": "US",
            "telephone_number": "757-387-2677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONKAM",
        "first_name": "RAYMOND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA11654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AIDE",
            "identifier": "HHA11654",
            "state": "DC"
        }
    ],
    "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 Mar 17, 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.