Active NPI
Vivian Angyiahen Fomukong
- Home Health Clinical Nurse Specialist
- Hyattsville, MD
National Provider Identifier
1811336803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Clinical Nurse Specialist
- License
- HHA8384
- Practice address
- 9276 Adelphi Rd Apt 204
Hyattsville, MD 20783-2029 - Phone
- (202) 378-6632
- NPI assigned
- Jun 23, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Home Health Clinical Nurse Specialist | 364SH0200X | HHA8384 | DC | Primary |
Addresses
Primary practice location
9276 Adelphi Rd Apt 204
Hyattsville, MD 20783-2029
Mailing address
9276 Adelphi Rd Apt 204
Hyattsville, MD 20783-2029
Phone (202) 378-6632
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HHA8384 | DC | MD | Home Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371945600000",
"number": "1811336803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9276 ADELPHI RD APT 204",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207832029",
"telephone_number": "202-378-6632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9276 ADELPHI RD APT 204",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207832029",
"telephone_number": "202-378-6632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOMUKONG",
"first_name": "VIVIAN",
"middle_name": "ANGYIAHEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-23",
"last_updated": "2013-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "364SH0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Home Health",
"state": "DC",
"license": "HHA8384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyattsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.