Lifetouch Family Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

LIFETOUCH FAMILY CLINIC LLC

Practice address

9801 Greenbelt Rd Ste 103
Lanham, MD 20706-6204

Phone

(202) 257-2130

NPI assigned

Dec 12, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Esabella Tebid Mbah, APRNNPI 1730511981

Title

NP

Phone

(202) 257-2130

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Esabella Mah Tebid Mbah, APRN

  • Family Nurse Practitioner
  • Lanham, MD
  • NPI 1730511981
  Authorized official Same address or phone

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1023729076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 GREENBELT RD STE 104",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 GREENBELT RD STE 103",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066204",
            "telephone_number": "202-257-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETOUCH FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "TEBID MBAH",
        "authorized_official_first_name": "ESABELLA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "202-257-2130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R174293",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Lanham, MD
• Providers in Lanham, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.