Ianua Health, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

IANUA HEALTH, LLC

Practice address

14 Rogers Rd Ste 211
North East, MD 21901-3612

Phone

(410) 280-7683

Fax

(610) 702-8056

NPI assigned

Jun 21, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Antonio Pedulla Jr., CRNPNPI 1518622455

Title

Owner/Nurse Practitioner

Phone

(610) 998-3902

Specialties & licenses 1

Addresses

Tax ID family

Ianua 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.

• Ianua Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • North East, MD
  • NPI 1033853213
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Antonio Pedulla Jr., CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • North East, MD
  • NPI 1518622455
  NPD Authorized official

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1093559304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 ROGERS RD STE 211",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013612",
            "telephone_number": "410-280-7683",
            "fax_number": "610-702-8056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 ROGERS RD STE 211",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013612",
            "telephone_number": "410-280-7683",
            "fax_number": "610-702-8056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IANUA HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "PEDULLA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "610-998-3902",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Leroy Hooper, M.D.
• Toby Guy Hoskins Jr., PA-C
• Robyn Marie Boettner Hunt, LCSW-C
• Lydia Sunyoung Hwang
• Ianua Health, LLC
• Edward Jay Ilioff
• Donald Murphy Jackson, D.D.S.,P.A.
• Jane McKown and Associates LLC
• Jesse Fairchild LLC
• Jicha Communication Services

• Community/Behavioral Health Agency in North East, MD
• Providers in North East, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.