Individual provider Active NPI

Hibo Ismail Haji Jama

  • Home Health Agency
  • Chantilly, VA
National Provider Identifier
1821643230
Registry record updated Aug 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HCO-2073 Issued in VA
Practice address
43555 White Cap Ter
Chantilly, VA 20152-5824
Phone
(703) 887-1702
NPI assigned
Aug 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HCO-2073 VA Primary

Addresses

Primary practice location

43555 White Cap Ter
Chantilly, VA 20152-5824

Mailing address

43555 White Cap Ter
Chantilly, VA 20152-5824
Phone (703) 887-1702

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
HCO-2073VAMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Excelhomehealthcare LLC Home Health CurrentSince Nov 3, 2019 Accepting new patients
Excelhomehealthcare LLC Home Health CurrentSince Dec 9, 2019 Accepting new patients

Organizations & group practices 2

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": "1564790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564790400000",
    "number": "1821643230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43555 WHITE CAP TER",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525824",
            "telephone_number": "703-887-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43555 WHITE CAP TER",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525824",
            "telephone_number": "703-887-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJI JAMA",
        "first_name": "HIBO",
        "middle_name": "ISMAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-03",
        "last_updated": "2019-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "HCO-2073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.