Conquest Health LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

CONQUEST HEALTH LLC

Practice address

12311 Snowden Woods Rd
Laurel, MD 20708-2492

Phone

(240) 603-1253

NPI assigned

Jan 13, 2020

Last updated

Sep 11, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kumli S AnyeNPI 1104221613

Title

Nurse Practitioner

Phone

(240) 603-1253

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Conquest Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Laurel, MD
  • NPI 1144999277

  O20200608000023

  Same enrollment

Tax ID family

Conquest Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Conquest Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Laurel, MD
  • NPI 1144999277
  NPD tax ID

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.

• Kumli Anye

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
  • NPI 1104221613

  Adult Health, DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631318400000",
    "number": "1043850415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12311 SNOWDEN WOODS RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 SNOWDEN WOODS RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082492",
            "telephone_number": "240-603-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONQUEST HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-13",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A",
        "authorized_official_last_name": "ANYE",
        "authorized_official_first_name": "KUMLI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "240-603-1253"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "laurel",
            "affiliation": "N",
            "address_1": "12311 Snowden Woods Rd",
            "city": "Laurel",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207082492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Laurel, MD
• Providers in Laurel, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2021; 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.