Individual Healthcare Provider
Mafon Fomujang, NURSE PRACTITIONER
Provider's NPPES record last updated: July 3, 2023
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1013442102
- Primary Specialty
- Nurse Practitioner — Psychiatric/Mental Health
- Practice Location
- Austin, Texas
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 3:52 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Nurse Practitioner
Psychiatric/Mental Health
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363LP0808X Clinical Nurse Specialist
Psychiatric/Mental Health
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 364SP0808X
Provider-Reported License Information
- Nurse Practitioner (Texas)
- 1048371
- Clinical Nurse Specialist (Ohio)
- 023666
- Nurse Practitioner (Ohio)
- APRN.CNP.023666
Practice Locations
Practice Location
2911 Medical Arts St Ste 10
Austin, Texas 78705-3302
Phone: (866) 473-0663
Additional Practice Location
10 Salt Creek Run
Peninsula, Ohio 44264-9461
Phone: (405) 549-6290
Additional Practice Location
12395 Mccracken Rd Ste A
Garfield Heights, Ohio 44125-2946
Phone: (216) 587-6727
Additional Practice Location
1930 Fulton Rd Nw # 103
Canton, Ohio 44709-3526
Phone: (330) 956-5936
Fax: (330) 956-5623
Additional Practice Location
13422 Kinsman Rd
Cleveland, Ohio 44120-4410
Phone: (866) 536-6038
Record Information
- Enumeration Date
- April 26, 2017
- Provider's NPPES Record Last Updated
- July 3, 2023
- Certification Date
- July 3, 2023
- NPISignal NPPES Dataset
- August 2026
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