Chantal Nyefen Fokum, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R162268 Issued in MD

Practice address

1512 Larkspur CT
Huntingtown, MD 20639-2314

Phone

(240) 593-3792

NPI assigned

Nov 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ennoble HC DMV LLCGroup PAC ID 9032517925, 112 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ennoble HC DMV LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Fulton, MD
  • NPI 1104492115

  DC, Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Rhaba Health LLC

  • Clinic/Center
  • Greenbelt, MD
  • NPI 1588353098

  DC, Multi-Specialty

  Medicare reassignment NPD Authorized official
• Rahel G. Yirga MD PC

  • Internal Medicine Physician
  • Sterling, VA
  • NPI 1558508184

  DC, Multi-Specialty

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1558026542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016211",
            "telephone_number": "551-295-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 LARKSPUR CT",
            "city": "HUNTINGTOWN",
            "state": "MD",
            "postal_code": "206392314",
            "telephone_number": "240-593-3792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39 V St NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200021329",
            "country_code": "US",
            "telephone_number": "551-295-8223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "962 Wayne Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209104433",
            "country_code": "US",
            "telephone_number": "551-295-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOKUM",
        "first_name": "CHANTAL",
        "middle_name": "NYEFEN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R162268",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R162268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• D & S Silpasuvan MD PA
• Madison Leigh Davern
• Heather Michelle Domyan
• Emad R Albanna MD PA
• Anthony Vincent Esser, LCPC
• Nicole Charlene Frey, LGPC
• Jennifer J Gosnell, A0166 MD
• Jessica M Hall, OD
• Roula Amal Hawit, MD
• Healing Circle Mental Health Inc.

• Adult Health Nurse Practitioner in Huntingtown, MD
• Providers in Huntingtown, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.