Nadine Carole Missiet Fogoum, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R205038 Issued in MD

Practice address

8625 Savannah River Rd
Laurel, MD 20724-1956

Phone

(202) 459-8904

NPI assigned

May 28, 2012

Last updated

Dec 23, 2024By the provider in NPPES

Sex

Female

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

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Axis Healthcare GroupGroup PAC ID 1254409550, 76 clinicians

Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Germantown Hospital Hospital, Germantown, MD, CCN 210065

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Axis Healthcare Group

  dba CareMind Health

  • Psychiatry Physician
  • Silver Spring, MD
  • NPI 1326295098

  DC

  Medicare reassignment Care Compare group NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  DC, MD

  Medicare reassignment Care Compare group NPD
• New Horizons Health Care Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frederick, MD
  • NPI 1720784945
  NPD Authorized official
• MCS, PC

  dba Mindoula Health, Inc.

  • Community/Behavioral Health Agency
  • Silver Spring, MD
  • NPI 1538717723

  Psychiatric/Mental Health

  NPD (past)
• The Freedom Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Gaithersburg, MD
  • NPI 1770060600
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Cross Health, Inc.

  dba Holy Cross Germantown Hospital

  • General Acute Care Hospital
  • Germantown, MD
  • NPI 1245655638
  Care Compare affiliation

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

{
    "created_epoch": "1338163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1093075731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8625 SAVANNAH RIVER RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207241956",
            "telephone_number": "202-459-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8625 SAVANNAH RIVER RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207241956",
            "telephone_number": "202-459-8904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8040 Georgia Ave Ste 170",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209104959",
            "country_code": "US",
            "telephone_number": "202-360-4787",
            "fax_number": "202-360-4787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISSIET FOGOUM",
        "first_name": "NADINE CAROLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-28",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R205038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mirab LLC (Transformations Center for Weight Loss-Laurel)
• Miso Medical Center
• Miso Medical Center
• Miso Medical Center
• Miso Medical Center
• Mitchell a Barber DPM ASC LLC
• Mitchell a Barber DPM LLC
• Colleen Denise Mitchell, PH.D.
• Denise Louise Mitchell, LCPC
• Evelyn Elizabeth Mitchell, LPC

• Psychiatric/Mental Health Nurse Practitioner in Laurel, MD
• Providers in Laurel, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.