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DERICK T MUKOM
NPI 1013892074
Case Manager/Care Coordinator in Glenn Dale, MD

Active since August 08, 2025
6911 FOUNTAIN PARK DR, GLENN DALE, MD 20769(832) 988-8970 Get Directions Write a Review

NPPES record last updated: October 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Derick T Mukom NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERICK T MUKOM (NPI 1013892074) is an individual case manager/care coordinator provider in Glenn Dale, Maryland and active in the NPI registry since August 2025.

NPPES Registry Identity

NPI1013892074
Entity TypeIndividualMale
Primary Taxonomy171M00000X
Provider Legal NameDERICK T MUKOM
Location Address6911 FOUNTAIN PARK DRGlenn Dale, MD 20769-9484
Mailing Address6911 Fountain Park DrGlenn Dale, MD 20769-9484 · (832) 988-8970
Phone(832) 988-8970
Sole ProprietorYes
Enumeration DateAugust 8, 2025
Last NPPES UpdateOctober 23, 2025
NPPES CertifiedOctober 23, 2025
✔ NPI 1013892074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers
Taxonomy Code171M00000X
Definition
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
Also ListedCommunity Health WorkerTaxonomy 172V00000X
6911 FOUNTAIN PARK DR, Glenn Dale, MD 20769
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

QUINTA MANJO MUKOM
Home Health Aide
6911 FOUNTAIN PARK DR
GLENN DALE, MD 20769
Prince George's County (301) 850-8402
ALAINGIERECE NKAMENKEEN
Case Manager/Care Coordinator
6911 FOUNTAIN PARK DR
GLENN DALE, MD 20769
Prince George's County (240) 556-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derick Mukom's NPI number?

The NPI number for Derick Mukom is 1013892074. It was assigned to this individual provider in the NPPES registry on August 8, 2025.

Where is Derick Mukom located?

Derick Mukom practices at 6911 Fountain Park Dr, Glenn Dale, MD 20769. The listed phone number is (832) 988-8970.

What is Derick Mukom's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

When was this NPI record last updated?

The NPPES record for Derick Mukom was last updated on October 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.