Active NPI
Carlene Gayle Banks
- Home Health Aide
- Hyattsville, MD
National Provider Identifier
1760086060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- R4367
- Practice address
- 6475 New Hampshire Ave Ste 604
Hyattsville, MD 20783-3280 - Phone
- (240) 481-7844
- Fax
- (240) 494-2603
- NPI assigned
- Nov 26, 2020
- Sex
- Female
- 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 | R4367 | MD | Primary |
Addresses
Primary practice location
6475 New Hampshire Ave Ste 604
Hyattsville, MD 20783-3280
Mailing address
PO Box 428
Mount Rainier, MD 20712-0428
Phone (301) 679-9653
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 |
|---|---|---|---|
| R4367 | MD | MD | Home Health Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ageless Healthcare LLC | Home Health Aide | Current | Accepting new patients |
Locations
6475 New Hampshire Ave
Ste 604
Hyattsville, MD 20783
Phone (240) 481-7844
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": "1606348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606348800000",
"number": "1760086060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 428",
"city": "MOUNT RAINIER",
"state": "MD",
"postal_code": "207120428",
"telephone_number": "301-679-9653",
"fax_number": "240-493-2603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6475 NEW HAMPSHIRE AVE STE 604",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207833280",
"telephone_number": "240-481-7844",
"fax_number": "240-494-2603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYLE BANKS",
"first_name": "CARLENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-26",
"last_updated": "2020-11-26",
"certification_date": "2020-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MD",
"license": "R4367",
"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 Nov 26, 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.