Individual provider Active NPI

Clementine Ajong Njinkeng

  • Family Nurse Practitioner
  • Lanham, MD
National Provider Identifier
1396007035
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R209831 Issued in MD
Practice address
9110 McHenry LN
Lanham, MD 20706-4158
Phone
(240) 644-2138
NPI assigned
Jun 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R209831 MD
Primary Care Nurse Practitioner 363LP2300X R209831 MD
Family Nurse Practitioner 363LF0000X R209831 MD Primary

Addresses

Primary practice location

9110 McHenry LN
Lanham, MD 20706-4158

Mailing address

9110 McHeny LN.
Lanham, MD 20706
Phone (240) 644-2138

Other names 1

  • Mrs. Clementine Ajongakog Atabong Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260214000233 NC Practitioner - Nurse Practitioner 4587042635 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elohim Housecall Doctors PAGroup PAC ID 0648550004, 5 clinicians
Authoracare CollectiveGroup PAC ID 3678558962, 11 clinicians

Practice addresses (Care Compare)

2500 Summit Ave
Greensboro, NC 27405-4522

2504 Summit Ave
Greensboro, NC 27405-4522
Phone (336) 621-2500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R209831MDMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Authoracare Collective CurrentSince Jan 6, 2026 Accepting new patients
Elohim Housecall Doctors Internal Medicine CurrentSince Jan 6, 2026 Accepting new patients
Authoracare Collective Past Accepting new patients

Locations

2504 Summit Ave
Greensboro, NC 27405
Phone (336) 621-2500

2500 Summit Ave
Greensboro, NC 27405
Phone (336) 621-2500

Interoperability endpoints

  • Direct secure messaging: clementine.njinkeng.1@14774.direct.athenahealth.com

Organizations & group practices 4

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": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1396007035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9110 MCHENY LN.",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "20706",
            "telephone_number": "240-644-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9110 MCHENRY LN",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207064158",
            "telephone_number": "240-644-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NJINKENG",
        "first_name": "CLEMENTINE",
        "middle_name": "AJONG",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "R209831",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R209831",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R209831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLEMENTINE",
            "last_name": "ATABONG",
            "middle_name": "AJONGAKOG",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.