Individual provider Active NPI

Adama M Fofanah

  • Nurse's Aide
  • Washington, DC
National Provider Identifier
1043984024
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
A00096100 Issued in MD
Practice address
2512 24TH St NE
Washington, DC 20018-2126
Phone
(202) 832-8340
Fax
(202) 832-8341
NPI assigned
Aug 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X A00096100 MD Primary

Addresses

Primary practice location

2512 24TH St NE
Washington, DC 20018-2126

Mailing address

15314 Tewkesbury PL
Upper Marlboro, MD 20774-8093
Phone (240) 707-2025

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
A00096100MDMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1043984024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15314 TEWKESBURY PL",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207748093",
            "telephone_number": "240-707-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 24TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200182126",
            "telephone_number": "202-832-8340",
            "fax_number": "202-832-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOFANAH",
        "first_name": "ADAMA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MD",
            "license": "A00096100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.