Individual provider Active NPI

Doris Ofodile, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
National Provider Identifier
1083457774
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP1059356 Issued in DC
Practice address
1647 Benning Rd NE Ste 300a
Washington, DC 20002-4572
Phone
(240) 707-1120
NPI assigned
Jun 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X R243706 MD
Psychiatric/Mental Health Registered Nurse 163WP0808X R243706 MD
Adult Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0809X R243706 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R243706 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP1059356 DC Primary

Addresses

Primary practice location

1647 Benning Rd NE Ste 300a
Washington, DC 20002-4572

Mailing address

1647 Benning Rd NE Ste 300a
Washington, DC 20002-4572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13621 Water Fowl Way
Upper Marlboro, MD 20774-7115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R243706MDMDPsychiatric/Mental Health Registered Nurse
NP1059356DCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arukah Health & Recovery Center LLC Current Accepting new patients

Locations

5000 Sunnyside Ave
Ste 101
Beltsville, MD 20705
Phone (240) 334-1121

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GECIDD/Endpoint/GECIDD

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1083457774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 BENNING RD NE STE 300A",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1647 BENNING RD NE STE 300A",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024572",
            "telephone_number": "240-707-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFODILE",
        "first_name": "DORIS",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MD",
            "license": "R243706",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R243706",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MD",
            "license": "R243706",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R243706",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "NP1059356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.