Individual provider Active NPI

Ngwe Mbaku Stella

  • Home Health Aide
  • Beltsville, MD
National Provider Identifier
1932640638
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
HHA12689 Issued in DC
Practice address
4805 Lincoln Ave
Beltsville, MD 20705-1528
Phone
(301) 529-0482
NPI assigned
Mar 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 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 HHA12689 DC Primary

Addresses

Primary practice location

4805 Lincoln Ave
Beltsville, MD 20705-1528

Mailing address

4805 Lincoln Avenue
Beltsville, MD 20705
Phone (301) 529-0482

Other identifiers 1

IdentifierTypeStateIssuer
1134956860MedicaidMD

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
HHA12689DCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1932640638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 LINCOLN AVENUE",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "20705",
            "telephone_number": "301-529-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 LINCOLN AVE",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207051528",
            "telephone_number": "301-529-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAKU STELLA",
        "first_name": "NGWE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA12689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134956860",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beltsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.