Active NPI
Jacques Leduc Edimo
- Home Health Aide
- Fort Washington, MD
National Provider Identifier
1750726816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- HHA6183
- Practice address
- 9706 Rooster LN
Fort Washington, MD 20744-5731 - Phone
- (202) 460-3036
- NPI assigned
- May 2, 2013
- Last updated
- May 2, 2013
- 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 | HHA6183 | DC | Primary |
Addresses
Primary practice location
9706 Rooster LN
Fort Washington, MD 20744-5731
Mailing address
9706 Rooster LN
Fort Washington, MD 20744-5731
Phone (202) 460-3036
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 |
|---|---|---|---|
| HHA6183 | DC | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367452800000",
"number": "1750726816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9706 ROOSTER LN",
"city": "FORT WASHINGTON",
"state": "MD",
"postal_code": "207445731",
"telephone_number": "202-460-3036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9706 ROOSTER LN",
"city": "FORT WASHINGTON",
"state": "MD",
"postal_code": "207445731",
"telephone_number": "202-460-3036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDIMO",
"first_name": "JACQUES",
"middle_name": "LEDUC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-02",
"last_updated": "2013-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "DC",
"license": "HHA6183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Washington, MD
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- Derrica Ifeakandu Edwards
- Jean Marie Efe Ndene
- Gladys Ebele Egwuatu, PMHNP-BC
- Enatalem Getachew Ejerssa
- Precious Mbinde Ekabe
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.