Active NPI
Koku Adela
- Driver
- Gaithersburg, MD
National Provider Identifier
1710375589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 8116
- Practice address
- 20440 Meadow Pond PL
Gaithersburg, MD 20886-1130 - Phone
- (301) 938-3208
- NPI assigned
- Jan 2, 2015
- Last updated
- Jan 2, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Driver | 172A00000X | 8116 | MD | Primary |
Addresses
Primary practice location
20440 Meadow Pond PL
Gaithersburg, MD 20886-1130
Mailing address
20440 Meadow Pond Place
Gaithersburg, MD 20886
Phone (301) 938-3208
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 |
|---|---|---|---|
| 8116 | MD | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420156800000",
"number": "1710375589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20440 MEADOW POND PLACE",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "20886",
"telephone_number": "301-938-3208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20440 MEADOW POND PL",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208861130",
"telephone_number": "301-938-3208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADELA",
"first_name": "KOKU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-02",
"last_updated": "2015-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "MD",
"license": "8116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.