Ida Diane Djomo Epse Kepsu

Individual provider Active NPI Contractor · Washington, DC

NPI 1760187918 · NPPES record last updated Apr 4, 2023

Key facts

NPI: 1760187918
Entity type: Individual (NPI type 1)
Primary specialty: Contractor 171W00000X
Practice address: 4660 Martin Luther King Jr Ave SW Ste A2
Washington, DC 20032-4933
Phone: (202) 318-0179
NPI assigned: Apr 4, 2023
Sex: Female
Sole proprietor: No

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.

Wellness Healthcare Clinics. LLC Mental Health Clinic/Center (Including Community Mental Health Center) · Washington, DC · NPI 1417432733

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Wellness Healthcare Clinics. LLC		Current since Apr 9, 2023	Accepting new patients

Locations

4660 Martin Luther King Jr Ave SW
Ste A3
Washington, DC 20032
Phone (202) 318-0179

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Contractor	171W00000X			Yes

Addresses

Primary practice location

4660 Martin Luther King Jr Ave SW Ste A2
Washington, DC 20032-4933

Mailing address

1203 Durham Dr
Bowie, MD 20721-3262

Other providers in Washington, DC

All providers in Washington, DC · Contractor in District of Columbia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.