Individual provider Active NPI

Anjeck A Mbah

  • Home Health Aide
  • Adelphi, MD
National Provider Identifier
1760957963
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA14009 Issued in DC
Practice address
1808 Metzerott Rd Apt 56
Adelphi, MD 20783-5123
Phone
(240) 338-7953
NPI assigned
Oct 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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 HHA14009 DC Primary

Addresses

Primary practice location

1808 Metzerott Rd Apt 56
Adelphi, MD 20783-5123

Mailing address

1808 Metzerott Rd Apt 56
Adelphi, MD 20783-5123

Other identifiers 1

IdentifierTypeStateIssuer
HHA14009MedicaidDC

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
HHA14009DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1760957963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 METZEROTT RD APT 56",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207835123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 METZEROTT RD APT 56",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207835123",
            "telephone_number": "240-338-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAH",
        "first_name": "ANJECK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA14009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA14009",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Adelphi, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.