Basil Teghen Ndum, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

0001301762 Issued in VA

Practice address

9105 Jousting LN
Upper Marlboro, MD 20772-4388

Phone

(240) 872-6598

NPI assigned

Jan 31, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Augustin Healthcare Inc

  • Developmental Disabilities Clinic/Center
  • Upper Marlboro, MD
  • NPI 1295664670
  NPD Authorized official
• St. Augustin Healthcare Services L.L.C

  • General Practice Registered Nurse
  • Upper Marlboro, MD
  • NPI 1831902915
  NPD Authorized official

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1063225142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 RICHMOND HWY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223053044",
            "telephone_number": "240-872-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 JOUSTING LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207724388",
            "telephone_number": "240-872-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUM",
        "first_name": "BASIL",
        "middle_name": "TEGHEN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "VA",
            "license": "0001301762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elmond Echaukian Ndifon
• Minete Agwesib Ndifon
• Priscilla Ojong Ndifon
• Synthia Mbulle Ndobe
• Irene Chidiebere Ndukwe, CRNP
• Sharma M Ndum
• Chukwuebuka Neboh
• Monica Nedd
• Venus Neely
• Neighborhood Nurse

• Administrator Registered Nurse in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Administrator Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.