Individual provider Active NPI

Bridget J Ntungwen

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Washington, DC
National Provider Identifier
1063955854
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
1026452 Issued in DC
Practice address
143 Kennedy St NW Ste 16
Washington, DC 20011-5268
Phone
(240) 374-8705
NPI assigned
Nov 28, 2016
Last updated
Nov 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 200255 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1026452 DC
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 1026452 DC Primary
Registered Nurse 163W00000X 102-6452 DC
Registered Nurse 163W00000X RN200255 MD

Addresses

Primary practice location

143 Kennedy St NW Ste 16
Washington, DC 20011-5268

Mailing address

7055 Samuel Morse Drive, Suite 200
Columbia, MD 21046
Phone (667) 701-9534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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

Enrollment IDStateProvider typePAC IDDetails
I20210407000013 DC Practitioner - Nurse Practitioner 3476960600 Reassigns benefits to 1 organization
I20210407003175 MD Practitioner - Nurse Practitioner 3476960600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13244 Musicmaster Dr
Silver Spring, MD 20904-6807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
102-6452DCMDRegistered Nurse
RN200255MDMDRegistered Nurse
200255MDMDPsychiatric/Mental Health Nurse Practitioner
1026452DCMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Healthcare Services LLC CurrentSince Mar 1, 2021 Accepting new patients
G & E Behavioral Health Services, LLC CurrentSince Mar 15, 2021 Accepting new patients
Psychogeriatric Services LLC CurrentSince Jul 8, 2022 Accepting new patients
G & E Behavioral Health Services, LLC PastSince Feb 14, 2021 Accepting new patients
Pinnacle Health Services Past Accepting new patients

Locations

4101 Old National Pike
Mount Airy, MD 21771
Phone (301) 829-0800

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23576/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1063955854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7055 SAMUEL MORSE DRIVE, SUITE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21046",
            "telephone_number": "667-701-9534",
            "fax_number": "301-917-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 KENNEDY ST NW STE 16",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115268",
            "telephone_number": "240-374-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NTUNGWEN",
        "first_name": "BRIDGET",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "200255",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "1026452",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "DC",
            "license": "1026452",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "102-6452",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "RN200255",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.