Individual provider Active NPI

Veronica Bisona Fodje

  • Licensed Practical Nurse
  • Takoma Park, MD
National Provider Identifier
1861106809
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP44196 Issued in MD
Practice address
602 Fairview Ave Apt 2
Takoma Park, MD 20912-5954
Phone
(240) 416-3609
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP44196 MD Primary

Addresses

Primary practice location

602 Fairview Ave Apt 2
Takoma Park, MD 20912-5954

Mailing address

602 Fairview Ave Apt 2
Takoma Park, MD 20912-5954
Phone (240) 416-3609

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

LicenseStateTypeSpecialty
LP44196MDMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1861106809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 FAIRVIEW AVE APT 2",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209125954",
            "telephone_number": "240-416-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 FAIRVIEW AVE APT 2",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209125954",
            "telephone_number": "240-416-3609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODJE",
        "first_name": "VERONICA",
        "middle_name": "BISONA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MD",
            "license": "LP44196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

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