Individual provider Active NPI

Yvonne Fonge

  • Registered Nurse
  • Columbia, MD
National Provider Identifier
1194147264
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN1031761 Issued in DC
Practice address
6420 Autumn Gold CT
Columbia, MD 21045-5419
Phone
(404) 512-0791
NPI assigned
Jan 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN1031761 DC Primary
Registered Nurse 163W00000X R207998 MD

Addresses

Primary practice location

6420 Autumn Gold CT
Columbia, MD 21045-5419

Mailing address

6420 Autumn Gold CT
Columbia, MD 21045-5419
Phone (404) 512-0791

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

State licenses

LicenseStateTypeSpecialty
RN1031761DCMDRegistered Nurse
R207998MDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1194147264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 AUTUMN GOLD CT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455419",
            "telephone_number": "404-512-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 AUTUMN GOLD CT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455419",
            "telephone_number": "404-512-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONGE",
        "first_name": "YVONNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-09",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1031761",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R207998",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.