Active NPI
Badjowa Nyan
- Assisted Living Facility
- Largo, MD
National Provider Identifier
1699166546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 16AL1095-8
- Practice address
- 10703 Pookey Way
Largo, MD 20774-6046 - Phone
- (301) 237-5384
- Fax
- (240) 510-3338
- NPI assigned
- Feb 13, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 16AL1095-8 | MD | Primary |
Addresses
Primary practice location
10703 Pookey Way
Largo, MD 20774-6046
Mailing address
1206 Northern Lights Dr
Upper Marlboro, MD 20774-6049
Phone (301) 237-5384
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16AL1095-8 | MD | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423785600000",
"number": "1699166546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1206 NORTHERN LIGHTS DR",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207746049",
"telephone_number": "301-237-5384",
"fax_number": "240-510-3338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10703 POOKEY WAY",
"city": "LARGO",
"state": "MD",
"postal_code": "207746046",
"telephone_number": "301-237-5384",
"fax_number": "240-510-3338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYAN",
"first_name": "BADJOWA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-13",
"last_updated": "2015-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "MD",
"license": "16AL1095-8",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Largo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.