Individual provider Active NPI

Brenda Eneke Eno, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Lanham, MD
National Provider Identifier
1083972970
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R178470 Issued in MD
Practice address
9332 Annapolis Rd # Suite 105
Lanham, MD 20706
Phone
(301) 708-9309
Fax
(800) 348-2155
NPI assigned
Apr 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN1016390 DC
Nurse's Aide 376K00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R178470 MD Primary

Addresses

Primary practice location

9332 Annapolis Rd # Suite 105
Lanham, MD 20706

Mailing address

9332 Annapolis Rd.
Suite 105
Lanham, MD 20706
Phone (240) 643-4430

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
I20220711000091 DC Practitioner - Nurse Practitioner 3678953486 Reassigns benefits to 1 organization
I20230207002882 MD Practitioner - Nurse Practitioner 3678953486 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1016390DCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joyride Healthcare, LLC CurrentSince Apr 6, 2024 Accepting new patients
Bloomcare Homes, LLC Current Accepting new patients
Supportive Care of Maryland LLC CurrentSince Jan 1, 2023 Accepting new patients
Joyride Healthcare, LLC Dba Joyride Integrative Psychiatry Psychiatric/Mental Health CurrentSince Jul 1, 2024 Accepting new patients
Joyride Healthcare, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

9332 Annapolis Rd
Ste 105
Lanham, MD 20706
Phone (240) 764-6874

4409 East West Hwy
Riverdale Park, MD 20737
Phone (301) 699-2000

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 6

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": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1083972970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9332 ANNAPOLIS RD.",
            "address_2": "SUITE 105",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "20706",
            "telephone_number": "240-643-4430",
            "fax_number": "202-503-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9332 ANNAPOLIS RD # SUITE 105",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "20706",
            "telephone_number": "301-708-9309",
            "fax_number": "800-348-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENO",
        "first_name": "BRENDA",
        "middle_name": "ENEKE",
        "credential": "CRNP-PMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN1016390",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R178470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.