Active NPI
Lynne Meryl Mofenson, MD
- Pediatrics Physician
- Silver Spring, MD
National Provider Identifier
1306393251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0038412
- Practice address
- 15117 Timberlake Dr
Silver Spring, MD 20905-4333 - Phone
- (301) 236-9319
- NPI assigned
- Sep 8, 2016
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0038412 | MD | Primary |
Addresses
Primary practice location
15117 Timberlake Dr
Silver Spring, MD 20905-4333
Mailing address
15117 Timberlake Dr
Silver Spring, MD 20905-4333
Phone (301) 236-9319
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0038412 | MD | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473292800000",
"number": "1306393251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15117 TIMBERLAKE DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209054333",
"telephone_number": "301-236-9319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15117 TIMBERLAKE DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209054333",
"telephone_number": "301-236-9319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOFENSON",
"first_name": "LYNNE",
"middle_name": "MERYL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-08",
"last_updated": "2016-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0038412",
"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 Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.