Individual provider Active NPI

Bendoline Bobimwo

  • Home Health Aide
  • Upper Marlboro, MD
National Provider Identifier
1861082547
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
NA0000812813 Issued in DC
Practice address
212 Settlers Way
Upper Marlboro, MD 20774-5770
Phone
(240) 467-7753
NPI assigned
Jan 26, 2021
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X NA0000812813 DC Primary

Addresses

Primary practice location

212 Settlers Way
Upper Marlboro, MD 20774-5770

Mailing address

212 Settlers Way
Upper Marlboro, MD 20774-5770
Phone (240) 467-7753

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
NA0000812813DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1861082547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 SETTLERS WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745770",
            "telephone_number": "240-467-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 SETTLERS WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745770",
            "telephone_number": "240-467-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBIMWO",
        "first_name": "BENDOLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "NA0000812813",
            "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 Jan 26, 2021; 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.