NPIMap

Organization Active NPI

Alta Healthcare Services LLC

  • Occupational Therapist
  • Germantown, MD
National Provider Identifier
1700398013
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
ALTA HEALTHCARE SERVICES LLC
Practice address
21506 Manor View Cir
Germantown, MD 20876-5924
Phone
(240) 506-1728
NPI assigned
Oct 26, 2017
Last updated
May 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Authorized official

Name
Hannah DibongeNPI 1932274735
Title
Ceo
Phone
(240) 506-1728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X NU
Infusion Therapy Registered Nurse 163WI0500X NU
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU Primary
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

21506 Manor View Cir
Germantown, MD 20876-5924

Mailing address

21506 Manor View Cir
Germantown, MD 20876-5924
Phone (240) 506-1728

Other practice location 1

101 Lakeforest Blvd
Gaithersburg, MD 20877-2611
Phone (240) 506-1728

National Provider Directory

National Provider Directory
Tax ID family
Alta Healthcare Services LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1700398013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21506 MANOR VIEW CIR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208765924",
            "telephone_number": "240-506-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21506 MANOR VIEW CIR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208765924",
            "telephone_number": "240-506-1728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Lakeforest Blvd",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208772611",
            "country_code": "US",
            "telephone_number": "240-506-1728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALTA HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-26",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "DIBONGE",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-506-1728"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.