Individual provider Active NPI

Azombuh Yanick Awungafac

  • Community/Behavioral Health Agency
  • Washington, DC
National Provider Identifier
1942988910
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Phone
(202) 894-6811
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2811 Pennsylvania Ave SE
Washington, DC 20020-3865

Mailing address

13302 Black Duck CT
Upper Marlboro, MD 20774-7011
Phone (424) 535-6255

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": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1942988910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13302 BLACK DUCK CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747011",
            "telephone_number": "424-535-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 PENNSYLVANIA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200203865",
            "telephone_number": "202-894-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWUNGAFAC",
        "first_name": "AZOMBUH",
        "middle_name": "YANICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "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 Jul 10, 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.

Verify at the official NPI Registry.