Individual provider Active NPI

Enyonam Jordan-Brangman, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ashburn, VA
National Provider Identifier
1114112604
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024174109 Issued in VA
Practice address
20130 Lakeview Center PLZ Ste 400
Ashburn, VA 20147-5905
Phone
(804) 207-6737
NPI assigned
Sep 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024174109 VA Primary
Adult Health Nurse Practitioner 363LA2200X 0024174109 VA
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 0001191728 VA

Addresses

Primary practice location

20130 Lakeview Center PLZ Ste 400
Ashburn, VA 20147-5905

Mailing address

42234 Highbank PL
Aldie, VA 20105-5725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, 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

Enrollment IDStateProvider typePAC IDDetails
I20170206000276 VA Practitioner - Nurse Practitioner 3678856259 Reassigns benefits to 2 organizations
I20170825001343 DC Practitioner - Nurse Practitioner 3678856259 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC CurrentSince Dec 1, 2016 Accepting new patients
Thrive Counseling LLC CurrentSince Jan 28, 2022 Accepting new patients
Live Well Healthcare PLLC Psychiatric/Mental Health Current Accepting new patients

Locations

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

20130 Lakeview Center Plz
Ste 400
Ashburn, VA 20147
Phone (700) 865-2144

8575 Rixlew Ln
Manassas, VA 20109
Phone (703) 257-9770

10432 Balls Ford Rd
Ste 300
Manassas, VA 20109
Phone (571) 229-8708

5310 Markel Rd
Ste 102
Richmond, VA 23230
Phone (804) 312-5498

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1189209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1114112604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42234 HIGHBANK PL",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201055725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20130 LAKEVIEW CENTER PLZ STE 400",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475905",
            "telephone_number": "804-207-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN-BRANGMAN",
        "first_name": "ENYONAM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-08",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024174109",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024174109",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0001191728",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

Verify at the official NPI Registry.