Clarisse Mafogang

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

NA0000812967 Issued in DC

Practice address

9510 Nordic Dr
Lanham, MD 20706-3630

Phone

(240) 413-8273

NPI assigned

Mar 29, 2021

Last updated

Mar 29, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1194302646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 NORDIC DR",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063630",
            "telephone_number": "240-413-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9510 NORDIC DR",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063630",
            "telephone_number": "240-413-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAFOGANG",
        "first_name": "CLARISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "DC",
            "license": "NA0000812967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse's Aide in Lanham, MD
• Providers in Lanham, MD by specialty
• Nurse's Aide in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.