Individual provider Active NPI

Khalifatu O Fawehinmi

  • Licensed Practical Nurse
  • Washington, DC
National Provider Identifier
1790345809
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN46835 Issued in MD
Practice address
3298 Fort Lincoln Dr NE Apt 1010
Washington, DC 20018-4342
Phone
(240) 475-5096
NPI assigned
Jun 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN46835 MD Primary

Addresses

Primary practice location

3298 Fort Lincoln Dr NE Apt 1010
Washington, DC 20018-4342

Mailing address

656 Charante CT Apt 104
Glen Burnie, MD 21061-5198
Phone (240) 475-5096

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL WASHINGTON Direct
CONNECT URL WASHINGTON Direct
CONNECT URL WASHINGTON Direct

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
LPN46835MDMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1790345809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 CHARANTE CT APT 104",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615198",
            "telephone_number": "240-475-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3298 FORT LINCOLN DR NE APT 1010",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200184342",
            "telephone_number": "240-475-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWEHINMI",
        "first_name": "KHALIFATU",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MD",
            "license": "LPN46835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WASHINGTON",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3298 Fort Lincoln Dr NE Apt 1010",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200184342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WASHINGTON",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3298 Fort Lincoln Dr NE Apt 1010",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200184342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WASHINGTON",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3298 Fort Lincoln Dr NE Apt 1010",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200184342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.