Active NPI
Fidelis N. Atabong
- Home Health Aide
- Laurel, MD
National Provider Identifier
1770919425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 3235 Purple Leaf LN
Laurel, MD 20724-6132 - Phone
- (240) 476-6795
- NPI assigned
- Sep 25, 2013
- Sex
- Male
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
3235 Purple Leaf LN
Laurel, MD 20724-6132
Mailing address
3235 Purple Leaf LN
Laurel, MD 20724-6132
Phone (240) 476-6795
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1770919425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3235 PURPLE LEAF LN",
"city": "LAUREL",
"state": "MD",
"postal_code": "207246132",
"telephone_number": "240-476-6795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3235 PURPLE LEAF LN",
"city": "LAUREL",
"state": "MD",
"postal_code": "207246132",
"telephone_number": "240-476-6795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATABONG",
"first_name": "FIDELIS",
"middle_name": "N.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-25",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.