Individual provider Active NPI

June Latisha-Ann Ottley, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chevy Chase, MD
National Provider Identifier
1083956437
Registry record updated Apr 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R155920 Issued in MD
Practice address
5550 Friendship Blvd Ste 590
Chevy Chase, MD 20815-7310
Phone
(410) 757-2077
Fax
(240) 235-8720
NPI assigned
Mar 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN1022763 DC
Adult Health Nurse Practitioner 363LA2200X R155920 MD
Gerontology Nurse Practitioner 363LG0600X R155920 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R155920 MD Primary

Addresses

Primary practice location

5550 Friendship Blvd Ste 590
Chevy Chase, MD 20815-7310

Mailing address

8044 Ians Aly
Laurel, MD 20724-6133
Phone (240) 431-1525

Other names 1

  • Ms. June Latisha-Ann Gilpin Former name

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
I20140814000212 DC Practitioner - Nurse Practitioner 2264659374 Reassigns benefits to 1 organization
I20150427001454 MD Practitioner - Nurse Practitioner 2264659374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arundel Mental Health Professionals LCGroup PAC ID 4981688173, 118 clinicians

Practice addresses (Care Compare)

5550 Friendship Blvd
Suite 590
Chevy Chase, MD 20815-7310
Phone (410) 757-2077

5850 Waterloo Rd
Suite 230
Columbia, MD 21045-1943
Phone (410) 757-2077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1022763DCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arundel Mental Health Professionals L.C. CurrentSince May 10, 2024 Accepting new patients
Kraus Behavioral Health LLC Psychiatric/Mental Health Past Accepting new patients
Arundel Mental Health Professionals LLC PastSince Jul 31, 2022 Accepting new patients

Locations

1511 Ritchie Hwy
Ste 202
Arnold, MD 21012
Phone (410) 757-5184

5550 Friendship Blvd
Ste 590
Chevy Chase, MD 20815
Phone (240) 945-2390

5850 Waterloo Rd
Ste 230
Columbia, MD 21045
Phone (240) 687-7826

1662 Village Grn
#B
Crofton, MD 21114

8133 Elliott Rd
Ste 236A
Easton, MD 21601
Phone (443) 906-3506

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.juneottley@149037.advancedmd-direct.com

Organizations & group practices 3

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": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712448000000",
    "number": "1083956437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8044 IANS ALY",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207246133",
            "telephone_number": "240-431-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 FRIENDSHIP BLVD STE 590",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208157310",
            "telephone_number": "410-757-2077",
            "fax_number": "240-235-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTLEY",
        "first_name": "JUNE",
        "middle_name": "LATISHA-ANN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "RN1022763",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R155920",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R155920",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R155920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUNE",
            "last_name": "GILPIN",
            "middle_name": "LATISHA-ANN",
            "prefix": "MS.",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chevy Chase, MD

Sources for this page

Verify at the official NPI Registry.