Daniel Ndamukong

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R149775 Issued in MD

Practice address

12008 Castle Pines LN
Waldorf, MD 20602-3183

Phone

(202) 258-5671

Fax

(240) 607-6760

NPI assigned

Jun 27, 2012

Last updated

Jan 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1447514187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 BUNKER HILL RD NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200173026",
            "telephone_number": "202-635-6133",
            "fax_number": "202-635-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12008 CASTLE PINES LN",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023183",
            "telephone_number": "202-258-5671",
            "fax_number": "240-607-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDAMUKONG",
        "first_name": "DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R149775",
            "primary": true
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "DC",
            "license": "RN963469",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• National Rehabilitation Hospital, Inc. (MedStar Health Physical Therapy at Waldorf Marketplace)
• National Vision, Inc. (America's Best Contacts & Eyeglasses)
• Sandra Navarra
• Nahum Francisco Navas, DPT
• Boris G Naydich, M.D.
• Rhoda Palmira Ndamukong, CRNP
• Clinton Chick Ndi
• Christina Lyn Neal, PA-C
• Neibauer Dental Care, PC (Neibauer Dental Care. - Waldorf)
• Chris Neibauer, DDS

• Psychiatric/Mental Health Nurse Practitioner in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.