Individual provider Active NPI

Angelique Mukunzi Kamagaju

  • In Home Supportive Care Agency
  • Phoenix, AZ
National Provider Identifier
1689209116
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
AL11290H Issued in AZ
Practice address
7932 W Hilton Ave
Phoenix, AZ 85043-7418
Phone
(623) 972-0191
Fax
(623) 440-2427
NPI assigned
Mar 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X AL11290H AZ Primary

Addresses

Primary practice location

7932 W Hilton Ave
Phoenix, AZ 85043-7418

Mailing address

7932 W Hilton Ave
Phoenix, AZ 85043-7418
Phone (623) 972-0191

Other practice location 1

7932 W Hilton Ave
Phoenix, AZ 85043-7418
Phone (623) 972-0191

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
AL11290HAZMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1689209116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7932 W HILTON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850437418",
            "telephone_number": "623-972-0191",
            "fax_number": "623-440-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7932 W HILTON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850437418",
            "telephone_number": "623-972-0191",
            "fax_number": "623-440-2427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7932 W Hilton Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850437418",
            "country_code": "US",
            "telephone_number": "623-972-0191",
            "fax_number": "623-440-2427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMAGAJU",
        "first_name": "ANGELIQUE",
        "middle_name": "MUKUNZI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "AZ",
            "license": "AL11290H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.

Verify at the official NPI Registry.