Individual provider Active NPI

Brenda Folefac Fonju, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1174102610
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R228896 Issued in MD
Practice address
6501 N Charles St
Baltimore, MD 21204-6819
Phone
(410) 938-3000
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R228896 MD Primary

Addresses

Primary practice location

6501 N Charles St
Baltimore, MD 21204-6819

Mailing address

14644 Wexhall Ter
Burtonsville, MD 20866-1911

Other practice location 1

4100 College Ave
Ellicott City, MD 21043-5506
Phone (443) 364-5500

Other practice location 2

1901 D St SE
Washington, DC 20003-2534
Phone (202) 913-7889

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Brenda.FolefacFonj@sheppardpratt.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210622000854 MD Practitioner - Nurse Practitioner 2365843877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
66.41 of 100Reported as group
Quality
30.12
Promoting interoperability
80
Improvement activities
40
Cost
57.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R228896MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sheppard Pratt Physicians, P.a. CurrentSince Jun 6, 2021 Accepting new patients
Likeminds Behavioral LLC Psychiatric/Mental Health CurrentSince Nov 1, 2022 Accepting new patients
Sheppard Pratt Health System, Inc Past Accepting new patients

Locations

4100 College Ave
Ellicott City, MD 21043
Phone (410) 465-3322

6501 N Charles St
Towson, MD 21204
Phone (410) 938-3000

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": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1174102610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14644 WEXHALL TER",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046819",
            "telephone_number": "410-938-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 College Ave",
            "address_purpose": "LOCATION",
            "city": "Ellicott City",
            "state": "MD",
            "postal_code": "210435506",
            "country_code": "US",
            "telephone_number": "443-364-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 D St SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200032534",
            "country_code": "US",
            "telephone_number": "202-913-7889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONJU",
        "first_name": "BRENDA",
        "middle_name": "FOLEFAC",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R228896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Brenda.FolefacFonj@sheppardpratt.org",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "6501 N Charles St",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212046819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.