Active NPI
Eugene Ufon Mbacham, MEDICAL PROVIDER
- Case Manager/Care Coordinator
- Washington, DC
National Provider Identifier
1851164651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- NA
- Practice address
- 1039 Bladensburg Rd NE
Washington, DC 20002-2922 - Phone
- (202) 507-8139
- NPI assigned
- Nov 2, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | NA | VA | Primary |
Addresses
Primary practice location
1039 Bladensburg Rd NE
Washington, DC 20002-2922
Mailing address
7810 Dogue Indian Cir
Lorton, VA 22079-2145
Phone (571) 494-0355
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": "1698883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698883200000",
"number": "1851164651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7810 DOGUE INDIAN CIR",
"city": "LORTON",
"state": "VA",
"postal_code": "220792145",
"telephone_number": "571-494-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1039 BLADENSBURG RD NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200022922",
"telephone_number": "202-507-8139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MBACHAM",
"first_name": "EUGENE",
"middle_name": "UFON",
"credential": "MEDICAL PROVIDER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-02",
"last_updated": "2023-11-02",
"certification_date": "2023-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "VA",
"license": "NA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Nov 2, 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.