Active NPI
Annette Fombu, RN
- Registered Nurse
- Silver Spring, MD
National Provider Identifier
1295101319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R198464
- Practice address
- 11006 Veirs Mill Rd
Suite L-15-299
Silver Spring, MD 20902-2582 - Phone
- (202) 681-9661
- NPI assigned
- Aug 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R198464 | MD | Primary |
Addresses
Primary practice location
11006 Veirs Mill Rd
Suite L-15-299
Silver Spring, MD 20902-2582
Mailing address
23 Fieldstone CT
Silver Spring, MD 20905-7436
Phone (240) 481-7684
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R198464 | MD | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Mobile Primary Health Care, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Nurse Practitioner
- Silver Spring, MD
- NPI 1487063640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439337600000",
"number": "1295101319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 FIELDSTONE CT",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209057436",
"telephone_number": "240-481-7684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11006 VEIRS MILL RD",
"address_2": "SUITE L-15-299",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209022582",
"telephone_number": "202-681-9661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOMBU",
"first_name": "ANNETTE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-12",
"last_updated": "2015-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MD",
"license": "R198464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.