Degha Fongod, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101263117 Issued in VA

Practice address

44121 Harry Byrd Hwy Ste 145
Ashburn, VA 20147-5667

Phone

(703) 879-4729

NPI assigned

Apr 29, 2013

Last updated

May 14, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1780029140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44121 HARRY BYRD HWY STE 145",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475667",
            "telephone_number": "703-879-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44121 HARRY BYRD HWY STE 145",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475667",
            "telephone_number": "703-879-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONGOD",
        "first_name": "DEGHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101263117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.