Individual provider Active NPI

Solomon Akufongwe Ndam, RN

  • Adult Psychiatric/Mental Health Registered Nurse
  • Washington, DC
National Provider Identifier
1104520576
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
RN1055423 Issued in DC
Practice address
4130 Hunt PL NE
Washington, DC 20019-3565
Phone
(202) 388-4300
Fax
(202) 388-4332
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X RN1055423 DC Primary

Addresses

Primary practice location

4130 Hunt PL NE
Washington, DC 20019-3565

Mailing address

11615 Sequoia LN
Beltsville, MD 20705-1471
Phone (240) 481-7413

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN1055423DCMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1104520576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11615 SEQUOIA LN",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207051471",
            "telephone_number": "240-481-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 HUNT PL NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193565",
            "telephone_number": "202-388-4300",
            "fax_number": "202-388-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDAM",
        "first_name": "SOLOMON",
        "middle_name": "AKUFONGWE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "DC",
            "license": "RN1055423",
            "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 Mar 29, 2023; 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.