Individual provider Active NPI

Elvis Agbortabi Tabi

  • Home Health Aide
  • Lanham, MD
National Provider Identifier
1891126124
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA9863 Issued in DC
Practice address
9907 Good Luck Rd
Apt. 201
Lanham, MD 20706-3247
Phone
(240) 467-1862
NPI assigned
Dec 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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 HHA9863 DC Primary

Addresses

Primary practice location

9907 Good Luck Rd
Apt. 201
Lanham, MD 20706-3247

Mailing address

9907 Good Luck Rd
Apt. 201
Lanham, MD 20706-3247
Phone (240) 467-1862

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
HHA9863DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1891126124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9907 GOOD LUCK RD",
            "address_2": "APT. 201",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063247",
            "telephone_number": "240-467-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9907 GOOD LUCK RD",
            "address_2": "APT. 201",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063247",
            "telephone_number": "240-467-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABI",
        "first_name": "ELVIS",
        "middle_name": "AGBORTABI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-12",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA9863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.