Individual provider Active NPI

Jeneba Bah

  • Home Health Agency
  • Upper Marlboro, MD
National Provider Identifier
1821784778
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
200002709 Issued in MD
Practice address
1318 Minnesota Way
Upper Marlboro, MD 20774-6060
Phone
(240) 565-9138
NPI assigned
Apr 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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 200002709 MD Primary

Addresses

Primary practice location

1318 Minnesota Way
Upper Marlboro, MD 20774-6060

Mailing address

1318 Minnesota Way
Upper Marlboro, MD 20774-6060
Phone (240) 565-9138

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
200002709MDMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1821784778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 MINNESOTA WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207746060",
            "telephone_number": "240-565-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 MINNESOTA WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207746060",
            "telephone_number": "240-565-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAH",
        "first_name": "JENEBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "200002709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; 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.