Individual provider Active NPI

Robert Freeboy Mukom

  • Home Health Aide
  • Hyattsville, MD
National Provider Identifier
1710604970
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
2508 Queens Chapel Rd Apt 103
Hyattsville, MD 20782-3648
Phone
(202) 258-2306
NPI assigned
Oct 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

2508 Queens Chapel Rd Apt 103
Hyattsville, MD 20782-3648

Mailing address

2508 Queens Chapel Rd Apt 103
Hyattsville, MD 20782-3648
Phone (202) 258-2306

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

NPI Registry JSON

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1710604970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 QUEENS CHAPEL RD APT 103",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823648",
            "telephone_number": "202-258-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 QUEENS CHAPEL RD APT 103",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823648",
            "telephone_number": "202-258-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKOM",
        "first_name": "ROBERT FREEBOY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-27",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.