LIFELINE INCORPORATED
Complete NPI Record 1083201727
Home Health in Washington, DC

NPI Status: Active since December 29, 2020

Contact Information

1615 KENILWORTH AVE NE
WASHINGTON, DC
ZIP 20019
Phone: (202) 588-8036

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Complete NPI Dataset

This page represents the complete record for NPI 1083201727. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1083201727
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 3200 SAINT LUKES LN
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: GWYNN OAK
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 212075629
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 4439391700
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 1615 KENILWORTH AVE NE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: WASHINGTON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: DC
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 200192010
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 2025888036
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 12/29/2020
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 12/29/2020
The date that a record was last updated or changed.
Authorized Official Last Name: MAKINDE
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: RHODA
The first name of the authorized official.
Authorized Official Title or Position: DIRECTOR
The title or position of the authorized official.
Authorized Official Telephone Number: 2025888036
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 251E00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Authorized Official Name Prefix Text: DR.
NPI Certification Date: 12/29/2020