Individual provider Active NPI

Rolly Ngueuleu Kameni

  • Home Health Agency
  • Upper Marlboro, MD
National Provider Identifier
1952103269
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA200004460 Issued in DC
Practice address
1501 Northern Lights Dr
Upper Marlboro, MD 20774-6093
Phone
(240) 495-9675
NPI assigned
Mar 26, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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 HHA200004460 DC Primary

Addresses

Primary practice location

1501 Northern Lights Dr
Upper Marlboro, MD 20774-6093

Mailing address

1501 Northern Lights Dr
Upper Marlboro, MD 20774-6093
Phone (240) 495-9675

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
HHA200004460DCMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1742947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1952103269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NORTHERN LIGHTS DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207746093",
            "telephone_number": "240-495-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NORTHERN LIGHTS DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207746093",
            "telephone_number": "240-495-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMENI",
        "first_name": "ROLLY",
        "middle_name": "NGUEULEU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-26",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "DC",
            "license": "HHA200004460",
            "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 Mar 26, 2025; 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.