Ennoble HC Dmv LLC - Medicare Primary Care in Fulton, MD

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Ennoble HC Dmv LLC is a medicare enrolled primary clinic (Family Medicine - Geriatric Medicine) in Fulton, Maryland. The current practice location for Ennoble HC Dmv LLC is 8115 Maple Lawn Blvd Ste 350, Fulton, Maryland. For appointments, you can reach them via phone at (862) 812-9010. The mailing address for Ennoble HC Dmv LLC is 39 V St Ne, Washington, District Of Columbia and phone number is (862) 812-9010.

Ennoble HC Dmv LLC is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1104492115. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (862) 812-9010.

Contact Information

Ennoble HC Dmv LLC
8115 Maple Lawn Blvd Ste 350
Fulton
MD 20759-2683
(862) 812-9010
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameEnnoble HC Dmv LLC
SpecialityFamily Medicine
Location8115 Maple Lawn Blvd Ste 350, Fulton, Maryland
Authorized Official Name and PositionKush Das (MANAGER)
Authorized Official Contact2019568233
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ennoble HC Dmv LLC
39 V St Ne
Washington
DC 20002-1329

Ph: (862) 812-9010		Ennoble HC Dmv LLC
8115 Maple Lawn Blvd Ste 350
Fulton
MD 20759-2683

Ph: (862) 812-9010

NPI Details:

NPI Number1104492115
Provider Enumeration Date06/01/2021
Last Update Date11/26/2025
Certification Date11/26/2025

Medicare PECOS Information:

Medicare PECOS PAC ID9032517925
Medicare Enrollment IDO20211007000017

Medical Identifiers

Medical identifiers for Ennoble HC Dmv LLC such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104492115NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207QG0300XFamily Medicine - Geriatric Medicine ()Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Ennoble HC Dmv LLC acts as a billing entity for following providers:
Provider NameHeather Kontaxis Loving
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1104861566
PECOS PAC ID: 4385531797
Enrollment ID: I20040301001143
Provider NameRobert a Loya
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1699959841
PECOS PAC ID: 6305927831
Enrollment ID: I20080131000073
Provider NameJohnnilyn Kutten
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417110933
PECOS PAC ID: 0749348332
Enrollment ID: I20081027000351
Provider NameChristina M Tafe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1235398702
PECOS PAC ID: 7618022799
Enrollment ID: I20090826000555
Provider NameJames R Eskew
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1114915592
PECOS PAC ID: 6406988484
Enrollment ID: I20100712000235
Provider NameSummit Gupta
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1942485321
PECOS PAC ID: 6406931674
Enrollment ID: I20110107000257
Provider NameRahel G Yirga
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1437121910
PECOS PAC ID: 2365536000
Enrollment ID: I20110404000080
Provider NameRoshni Malik
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1326360967
PECOS PAC ID: 0648447060
Enrollment ID: I20120125000398
Provider NameDanielle E Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831478890
PECOS PAC ID: 0941468979
Enrollment ID: I20120222000812
Provider NameMaria Read
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588877609
PECOS PAC ID: 9739341801
Enrollment ID: I20120507000604
Provider NameMilca a Kaplan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457611774
PECOS PAC ID: 7517113301
Enrollment ID: I20120810000040
Provider NameZalwonaka L Gainer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336322676
PECOS PAC ID: 2163500455
Enrollment ID: I20130320000214
Provider NameLinda Firth
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1477690832
PECOS PAC ID: 2365680931
Enrollment ID: I20130522000085
Provider NameBarbara Anita Clorey
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1073607669
PECOS PAC ID: 1456404193
Enrollment ID: I20150303000919
Provider NameBahiyyih Clarke
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1457648818
PECOS PAC ID: 7719206416
Enrollment ID: I20150430001816
Provider NameKristen E Dickert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477949758
PECOS PAC ID: 2062732241
Enrollment ID: I20150529001210
Provider NameMenbere Bahru
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1528130218
PECOS PAC ID: 4789787284
Enrollment ID: I20150804003445
Provider NameAarti S Vakil
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1811914658
PECOS PAC ID: 6103884390
Enrollment ID: I20151202002589
Provider NameHanna Tokon-yilma
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508217498
PECOS PAC ID: 3274811765
Enrollment ID: I20161104000106
Provider NamePatricia Chang Carpenter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730505546
PECOS PAC ID: 5799903738
Enrollment ID: I20170227000200
Provider NameAdediwura Ajadi Jolaoso
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1801312053
PECOS PAC ID: 6305106022
Enrollment ID: I20180129000229
Provider NameDorin V Takwa
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932582517
PECOS PAC ID: 1850604638
Enrollment ID: I20180227000179
Provider NameAimee Punsalang
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083268973
PECOS PAC ID: 2860721578
Enrollment ID: I20190905002053
Provider NameLilian Osei
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568007862
PECOS PAC ID: 7719315241
Enrollment ID: I20200317001250
Provider NameChinwe Edith Agbim
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831616010
PECOS PAC ID: 5698104081
Enrollment ID: I20200407000098
Provider NameKatherine Archut
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548661283
PECOS PAC ID: 5698997286
Enrollment ID: I20200414002021
Provider NameCierra Jade Relyea
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669083416
PECOS PAC ID: 3274952676
Enrollment ID: I20201005002037
Provider NameDana L Colvin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386163475
PECOS PAC ID: 6305191362
Enrollment ID: I20210419001654
Provider NameTouko Barthelemy Leuga
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174132682
PECOS PAC ID: 0547678526
Enrollment ID: I20210517000469
Provider NameBernadine Ihediohanma
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457942575
PECOS PAC ID: 9739588625
Enrollment ID: I20210526000519
Provider NameJulienne Ebongue
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1255970380
PECOS PAC ID: 3476952300
Enrollment ID: I20210526002369
Provider NameSjamer Chere
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659922854
PECOS PAC ID: 8921405085
Enrollment ID: I20210916002221
Provider NameMatia Lavonne Kilgore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730775958
PECOS PAC ID: 0547659146
Enrollment ID: I20211123000049
Provider NameHermon Mesfin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760157374
PECOS PAC ID: 9739577545
Enrollment ID: I20211203000912
Provider NameChantal Fokum
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558026542
PECOS PAC ID: 8224429998
Enrollment ID: I20220107000170
Provider NamePhanta Jah
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174296461
PECOS PAC ID: 1153714308
Enrollment ID: I20220210001108
Provider NamePatience M Chia
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427664200
PECOS PAC ID: 1850785221
Enrollment ID: I20220301000500
Provider NameCody Eccard
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1053829796
PECOS PAC ID: 6305106196
Enrollment ID: I20220503002074
Provider NameIvan H Racadag
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083062392
PECOS PAC ID: 0648568121
Enrollment ID: I20220606002978
Provider NameMonica Bruney
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1245854348
PECOS PAC ID: 2961824230
Enrollment ID: I20220722001159
Provider NameMesfin Wanna
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548981004
PECOS PAC ID: 8729463161
Enrollment ID: I20220921000230
Provider NameCyriac Nchang
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427589878
PECOS PAC ID: 1254750193
Enrollment ID: I20221019001307
Provider NameYvette Mujarwanda
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083365985
PECOS PAC ID: 6305213182
Enrollment ID: I20221110001583
Provider NameWilliam Cheatham
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1467415638
PECOS PAC ID: 8921475658
Enrollment ID: I20230106000954
Provider NameGina Bryant
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497472484
PECOS PAC ID: 6709257942
Enrollment ID: I20230126003220
Provider NameLori Jenkins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154891000
PECOS PAC ID: 0446599526
Enrollment ID: I20230216001105
Provider NameAshleigh Wallace
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881369536
PECOS PAC ID: 4587053152
Enrollment ID: I20230419000583
Provider NameLauren M Tracy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790436749
PECOS PAC ID: 2668867599
Enrollment ID: I20230519000425
Provider NameConcilia Mbawuike
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336837574
PECOS PAC ID: 8022474428
Enrollment ID: I20230522003479
Provider NameChristina Pritchard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538851704
PECOS PAC ID: 4385002740
Enrollment ID: I20230617000052
Provider NameNermeen Helmey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164209847
PECOS PAC ID: 6608220553
Enrollment ID: I20231002000319
Provider NameNashwa Abdalla
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396524278
PECOS PAC ID: 9032567763
Enrollment ID: I20231119000055
Provider NameTheresa Juana Kamanda
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750096962
PECOS PAC ID: 3072974492
Enrollment ID: I20231205000248
Provider NameJoshua Igbinosun
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407533581
PECOS PAC ID: 3173972213
Enrollment ID: I20231214000374
Provider NameAyuk B Etang
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1013679273
PECOS PAC ID: 1557750536
Enrollment ID: I20240305002756
Provider NameEdna Baffoe-bonnie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982117388
PECOS PAC ID: 8224399241
Enrollment ID: I20240308000651
Provider NameGeraldine Tekwe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528818697
PECOS PAC ID: 9133569395
Enrollment ID: I20240612002950
Provider NameCharbene Olugbemi
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1598473043
PECOS PAC ID: 4486198058
Enrollment ID: I20240708000882
Provider NameDona Zainab Conteh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578314423
PECOS PAC ID: 0547703712
Enrollment ID: I20240708004194
Provider NameNermala Vasu Diven
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497330344
PECOS PAC ID: 1355780750
Enrollment ID: I20240911003532
Provider NameAnna Rica Chico Castro
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689449357
PECOS PAC ID: 2062953185
Enrollment ID: I20240917001716
Provider NameSidya Thomas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083372577
PECOS PAC ID: 8921549064
Enrollment ID: I20240917002504
Provider NameRajdeep Parmar
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1518939008
PECOS PAC ID: 1456445196
Enrollment ID: I20241002004253
Provider NameShawnette T Goines
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093593196
PECOS PAC ID: 2163874587
Enrollment ID: I20241016001903
Provider NameEline Patricia Narcisse
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306690607
PECOS PAC ID: 7315479664
Enrollment ID: I20241017001937
Provider NameAnna Dinello
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982466348
PECOS PAC ID: 7719323153
Enrollment ID: I20241121004473
Provider NameSenait Mehari
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437980240
PECOS PAC ID: 2264967579
Enrollment ID: I20241212002293
Provider NameKaren Marshall
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841413762
PECOS PAC ID: 6800159187
Enrollment ID: I20241216003406
Provider NameRebeka Nazneen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669173431
PECOS PAC ID: 2961938188
Enrollment ID: I20250123000257
Provider NameKimberly Weiss
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1376789859
PECOS PAC ID: 0143406165
Enrollment ID: I20250129000787
Provider NameRenee Brack
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790293215
PECOS PAC ID: 5193087252
Enrollment ID: I20250131001347
Provider NameSaba Ademe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124760319
PECOS PAC ID: 8224405709
Enrollment ID: I20250221000758
Provider NameSandra Casey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548293475
PECOS PAC ID: 2860496775
Enrollment ID: I20250310000015
Provider NameWarnakulasuriya Lowe
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417661257
PECOS PAC ID: 5991245581
Enrollment ID: I20250317000817
Provider NameKadiatu Kamara
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992542625
PECOS PAC ID: 7810418167
Enrollment ID: I20250423002842
Provider NameKennedy Ugbodu
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891449856
PECOS PAC ID: 9032631262
Enrollment ID: I20250501003350
Provider NamePrecious Nwala
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588484703
PECOS PAC ID: 8527581651
Enrollment ID: I20250703004136
Provider NameOlamide Odetoye
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306557830
PECOS PAC ID: 0446618557
Enrollment ID: I20250708000286
Provider NameSabik Sadiq
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669059648
PECOS PAC ID: 0749783975
Enrollment ID: I20250912001113
Provider NameRebecca Mensah
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194504068
PECOS PAC ID: 9830686195
Enrollment ID: I20251013000809
Provider NameMark Bradshaw
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1316107428
PECOS PAC ID: 6608049275
Enrollment ID: I20251218004325
Provider NameSara Dunne
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1053671859
PECOS PAC ID: 1355597188
Enrollment ID: I20260209003717
Provider NameStefanie Cokley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366235376
PECOS PAC ID: 4789194820
Enrollment ID: I20260220001258
Provider NameLael Little
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730494980
PECOS PAC ID: 1759560279
Enrollment ID: I20260223000014
Provider NameIsaac Esene
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1194411801
PECOS PAC ID: 6901380070
Enrollment ID: I20260318000519
Provider NameJulie Richitt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700734134
PECOS PAC ID: 3072081371
Enrollment ID: I20260509000195
Provider NameJackson Son
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265291272
PECOS PAC ID: 5496275877
Enrollment ID: I20260512004584
Provider NameTiffany Leigh Henry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386450187
PECOS PAC ID: 3476024928
Enrollment ID: I20260622002329

Reviews and Comments

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.