Individual provider Active NPI

Kwekam Didi Parfait Fongang

  • Case Manager/Care Coordinator
  • Washington, DC
National Provider Identifier
1134824238
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Phone
(202) 597-1146
NPI assigned
Mar 30, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X DC Primary

Addresses

Primary practice location

2811 Pennsylvania Ave SE
Washington, DC 20020-3865

Mailing address

5914 85TH Ave
New Carrollton, MD 20784-2802
Phone (240) 584-3902

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

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1134824238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5914 85TH AVE",
            "city": "NEW CARROLLTON",
            "state": "MD",
            "postal_code": "207842802",
            "telephone_number": "240-584-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 PENNSYLVANIA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200203865",
            "telephone_number": "202-597-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONGANG",
        "first_name": "KWEKAM",
        "middle_name": "DIDI PARFAIT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "DC",
            "license": null,
            "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 10, 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.