Nykenji Nicole Fogg, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20525 Issued in MD

Practice address

5881 Shady Side Rd
Churchton, MD 20733-9637

Phone

(443) 822-7273

NPI assigned

Sep 14, 2021

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 DC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

81.45 of 100Reported as group

Quality

67.28

Promoting interoperability

98

Improvement activities

40

Cost

72.57

Medicare enrollment (NPD)

Enrolled

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.

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  dba Annapolis Surgical Oncology Associates

  • Surgery Physician
  • Annapolis, MD
  • NPI 1649248485

  DC, Single Specialty

  Medicare reassignment NPD
• Luminis Health Medical Group, LLC

  • Psychiatry Physician
  • Lanham, MD
  • NPI 1104051440
  NPD
• Luminis Health Medical Group, LLC

  dba LH Primary Care North Hanson

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1720835010

  Single Specialty

  NPD

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1164192068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 296",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210370296",
            "telephone_number": "202-446-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5881 SHADY SIDE RD",
            "city": "CHURCHTON",
            "state": "MD",
            "postal_code": "207339637",
            "telephone_number": "443-822-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGG",
        "first_name": "NYKENJI",
        "middle_name": "NICOLE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Body & Soul Acupuncture LLC
• Raleigh L Burch Jr.
• Churchton Dental Care
• Christina Cole, LCPC
• Nathan Fincher
• Dominique Forsman
• Shakira Garrison
• Gyan C Surana MD.PC.
• Kaitlynn Labille
• Level Up Spine Care and Rehab

• Clinical Social Worker in Churchton, MD
• Providers in Churchton, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.