Gladys Momoh

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R246488 Issued in MD

Practice address

10081 Campus Way S
Upper Marlboro, MD 20774-2103

Phone

(202) 704-2920

NPI assigned

Aug 14, 2012

Last updated

Mar 20, 2025By the provider in NPPES

Sex

Female

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

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bon Ridge Wellness LLCGroup PAC ID 1951775337, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bon Ridge Wellness, LLC

  • Clinical Social Worker
  • Windsor Mill, MD
  • NPI 1922710995
  Medicare reassignment Care Compare group NPD
• Sky Point Psychiatric and Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Upper Marlboro, MD
  • NPI 1538002910

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1043567670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MINNESOTA WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207746065",
            "telephone_number": "202-704-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10081 CAMPUS WAY S",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207742103",
            "telephone_number": "202-704-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMOH",
        "first_name": "GLADYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R246488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Onyoli Mofa
• Tadjoua Marinette Mogou
• Christabelle Joso Molinga
• Joseph Christian Momnougui
• Alvine Momo Azobou, PA-C
• Matthew Patrick Momoh
• Vision Moncha
• Kaila Monk, BS
• Tawana Monroe, MASSAGE THERAPIST
• Daniel Montue

• Psychiatric/Mental Health Nurse Practitioner in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.