Individual provider Active NPI

Susane Njomo, DNP, FNP-BC

  • Family Nurse Practitioner
  • Elkridge, MD
National Provider Identifier
1275077083
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173891 Issued in VA
Practice address
6095 Marshalee Dr
Elkridge, MD 21075-6053
Phone
(855) 247-8474
NPI assigned
Dec 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024173891 VA Primary

Addresses

Primary practice location

6095 Marshalee Dr
Elkridge, MD 21075-6053

Mailing address

6095 Marshalee Dr
Elkridge, MD 21075-6053
Phone (855) 247-8474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170504000135 DC Practitioner - Nurse Practitioner 3173800968 Reassigns benefits to 1 organization
I20171204000456 VA Practitioner - Nurse Practitioner 3173800968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024173891VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Mar 1, 2023 Accepting new patients
Medexpress Urgent Care, PC - Virginia CurrentSince Sep 1, 2022 Accepting new patients
Privia Medical Group, LLC CurrentSince Mar 1, 2023 Accepting new patients
Medexpress Urgent Care, PC - Virginia CurrentSince Sep 1, 2022 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

9401 Route 29
Ste 302
Fairfax, VA 22031
Phone (703) 870-3750

3903 Fair Ridge Dr
Ste Q
Fairfax, VA 22033
Phone (703) 454-5132

8644 Sudley Rd
#220
Manassas, VA 20110

1336 W Main St
Salem, VA 24153
Phone (540) 389-0374

1945 Old Gallows Rd
Ste 405
Vienna, VA 22182

423 Fortress Blvd
Morgantown, WV 26508
Phone (844) 852-9510

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: susane.njomo.1@8042.direct.athenahealth.com

Organizations & group practices 5

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": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1275077083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6095 MARSHALEE DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756053",
            "telephone_number": "855-247-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 MARSHALEE DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756053",
            "telephone_number": "855-247-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NJOMO",
        "first_name": "SUSANE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.