Divine Mofor Fominka

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

HHA200005765 Issued in DC

Practice address

908 Lake Front Dr
Bowie, MD 20721-2950

Phone

(719) 725-9850

NPI assigned

Dec 12, 2025

Last updated

Dec 12, 2025By 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 1

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": "1765497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1841154010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 LAKE FRONT DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212950",
            "telephone_number": "719-725-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 LAKE FRONT DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212950",
            "telephone_number": "719-725-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMINKA",
        "first_name": "DIVINE",
        "middle_name": "MOFOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-12",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "HHA200005765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Focus Behavioral Health
• Muted Fofung, RPH
• Clovis Tah Fokum
• Ibukunoluwa A Folarin
• Ashu Joseph Folifac Nkafu
• Ananga Isaac Fominyam
• Wilson Chick Fanso Fomukom
• Ferdinand Fomukong Ewuozieh
• Kah Blandine Fon Nwiekeri
• Larissa Fon Tendo

• Home Health Aide in Bowie, MD
• Providers in Bowie, MD by specialty
• Home Health Aide in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; 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.