IDETTE BRUMBAUGH, RN — NPI 1063178820 (CMS-Certified Home Health Care & Skilled Nursing Agency in DAMASCUS, MD)

CMS-1500 Box 24J / 33a • NPI

1063178820

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

163WH0200X

CMS-Certified Home Health Care & Skilled Nursing Agency

Box 32 Service Location & ZIP+4

30 SHELLDRAKE CT, DAMASCUS, MD, 20872-2614

✓ 9-Digit EDI 837 ZIP+4 (20872-2614)

Practice Phone & Referral Fax

(301) 758-0866

Fax: (301) 253-5174

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1063178820 (IDETTE BRUMBAUGH, RN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1063178820` (NPI-1 Individual Practitioner)
Provider / Legal Name	IDETTE BRUMBAUGH, RN
Plain-English Specialty	CMS-Certified Home Health Care & Skilled Nursing Agency NUCC Code: `163WH0200X` (Registered Nurse, Home Health)
Certifying / Licensing Body	CMS Home Health Conditions of Participation / CHAP / ACHC
Practice Location Address	30 SHELLDRAKE CT, DAMASCUS, MD, 20872-2614
Practice Telephone / Fax	Tel: (301) 758-0866 \| Fax: (301) 253-5174
Administrative Mailing Address	30 SHELLDRAKE CT, DAMASCUS, MD, 20872-2614
Enumeration & Last Sync	Enumerated: 2021-11-16 \| CMS Record Updated: 2021-11-29

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

30 SHELLDRAKE CT, DAMASCUS, MD, 20872-2614

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Plain-English Taxonomy & CMS Crosswalk (163WH0200X)

What Does Taxonomy Code 163WH0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163WH0200X translates to:
"CMS-Certified Home Health Care & Skilled Nursing Agency"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: CMS Home Health Conditions of Participation / CHAP / ACHC
Clinical Scope: Post-hospital discharge recovery, homebound skilled nursing, physical therapy after joint replacement, or home IV antibiotic therapy.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (IDETTE BRUMBAUGH, RN)

Typical CPT / Diagnostic Procedures:

In-Home Skilled Nursing Wound Care, Ostomy & Catheter Management
Home Intravenous Antibiotic Infusion (OPAT) & Post-Stroke Rehabilitation

Common Therapeutic Classes:

Home Infusion Antimicrobials, Anticoagulants & Insulin Titration

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`163WC0400X` — Registered Nurse, Case Management Plain English: Licensed & Credentialed Registered Nurse, Case Management	State: MD \| License: `R107452` \| Primary: Secondary
`163WC1500X` — Registered Nurse, Community Health Plain English: Licensed & Credentialed Registered Nurse, Community Health	State: MD \| License: `R107452` \| Primary: Secondary
`163WC1600X` — Registered Nurse, Continuing Education/Staff Development Plain English: Licensed & Credentialed Registered Nurse, Continuing Education/Staff Development	State: MD \| License: `R107452` \| Primary: Secondary
`163WW0000X` — Registered Nurse, Wound Care Plain English: Licensed & Credentialed Registered Nurse, Wound Care	State: MD \| License: `R107452` \| Primary: Secondary
`163WH0200X` — Registered Nurse, Home Health Plain English: CMS-Certified Home Health Care & Skilled Nursing Agency	State: MD \| License: `R107452` \| Primary: Yes (Primary)

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IDETTE BRUMBAUGH, RN (NPI #1063178820)