Individual provider Active NPI

Comfort Etah Takang

  • Licensed Practical Nurse
  • Washington, DC
National Provider Identifier
1720340839
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN1006870 Issued in DC
Practice address
2512 24TH St NE
Washington, DC 20018-2126
Phone
(202) 832-8340
Fax
(202) 832-8341
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN1006870 DC Primary

Addresses

Primary practice location

2512 24TH St NE
Washington, DC 20018-2126

Mailing address

7826 Eastern Ave NW
Ll18A
Washington, DC 20012-1324
Phone (202) 722-7776

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

LicenseStateTypeSpecialty
LPN1006870DCMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
JD Nursing & Management Ser Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1720340839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7826 EASTERN AVE NW",
            "address_2": "LL18A",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200121324",
            "telephone_number": "202-722-7776",
            "fax_number": "202-722-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 24TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200182126",
            "telephone_number": "202-832-8340",
            "fax_number": "202-832-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKANG",
        "first_name": "COMFORT",
        "middle_name": "ETAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DC",
            "license": "LPN1006870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.

Verify at the official NPI Registry.