Individual provider Active NPI

Justine Mbianda, CEO

  • Home Health Agency
  • Silver Spring, MD
National Provider Identifier
1922733591
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
R4765 Issued in MD
Practice address
13105 Collingwood Ter
Silver Spring, MD 20904-1417
Phone
(301) 803-9690
Fax
(301) 900-4599
NPI assigned
Jul 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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 R4765 MD Primary

Addresses

Primary practice location

13105 Collingwood Ter
Silver Spring, MD 20904-1417

Mailing address

13105 Collingwood Ter
Silver Spring, MD 20904-1417
Phone (301) 379-9111

Other names 1

  • Ms. Justine Mbianda Other name

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
R4765MDMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Choral Healthcare Services, Inc. CurrentSince Nov 26, 2023 Accepting new patients

Organizations & group practices 1

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": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1922733591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13105 COLLINGWOOD TER",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041417",
            "telephone_number": "301-379-9111",
            "fax_number": "301-900-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13105 COLLINGWOOD TER",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041417",
            "telephone_number": "301-803-9690",
            "fax_number": "301-900-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBIANDA",
        "first_name": "JUSTINE",
        "credential": "CEO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "R4765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "MBIANDA",
            "prefix": "MS.",
            "credential": "CEO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.