Active NPI
Milton Fongang
- Home Health Aide
- Landover, MD
National Provider Identifier
1700481876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- HHA15467
- Practice address
- 3211 75TH Ave Apt 102
Landover, MD 20785-1932 - Phone
- (240) 424-1390
- NPI assigned
- Dec 4, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | HHA15467 | MD | Primary |
Addresses
Primary practice location
3211 75TH Ave Apt 102
Landover, MD 20785-1932
Mailing address
3211 75TH Ave Apt 102
Landover, MD 20785-1932
Phone (240) 424-1390
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.icsprograms.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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HHA15467 | MD | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1700481876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3211 75TH AVE APT 102",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207851932",
"telephone_number": "240-424-1390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3211 75TH AVE APT 102",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207851932",
"telephone_number": "240-424-1390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONGANG",
"first_name": "MILTON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-04",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MD",
"license": "HHA15467",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.icsprograms.com",
"affiliation": "N",
"address_1": "3211 75th Ave Apt 102",
"city": "Landover",
"state": "MD",
"country_code": "US",
"postal_code": "207851932",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Landover, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.