Healthcare Provider Details

I. General information

NPI: 1073053245
Provider Name (Legal Business Name): MARY CATHERINE FRIPP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 18TH ST NE
WASHINGTON DC
20018-2738
US

IV. Provider business mailing address

4926 9TH ST NW
WASHINGTON DC
20011-4508
US

V. Phone/Fax

Practice location:
  • Phone: 202-529-6510
  • Fax:
Mailing address:
  • Phone: 202-213-9706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA00604789
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200001675
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: