Glenise Mbah, DNP, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R235367 Issued in MD

Practice address

10755 Falls Rd Ste 260
Timonium, MD 21093-4520

Phone

(410) 583-2955

NPI assigned

Nov 6, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: glenise.mbah.1@16549.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/16549/brand/1/csg/1/fhir/r4

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.

• Maryland Children Health Center

  • Primary Care Clinic/Center
  • Oxon Hill, MD
  • NPI 1225872740
  NPD (past)
• Maryland Children Health Center

  • Primary Care Clinic/Center
  • Glenn Dale, MD
  • NPI 1558635235
  NPD (past)

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1104255470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 35TH PL",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207052709",
            "telephone_number": "240-481-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10755 FALLS RD STE 260",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210934520",
            "telephone_number": "410-583-2955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9312 Piney Branch Rd Apt 304",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209032809",
            "country_code": "US",
            "telephone_number": "240-481-3318",
            "fax_number": "202-545-0934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBAH",
        "first_name": "GLENISE",
        "credential": "DNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R235367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxim Healthcare Services, Inc.
• Maxim Healthcare Services, Inc.
• Lisa F. May-Sachs, LCSW-C
• Lori May-Sachs, PT
• Henry G Mayaka, COTA/L
• Tierra McCarter
• Elizabeth McCarthy, LCPC
• Lisa McCarthy
• Rebecca McDevitt, CRNP
• Elizabeth Ann McDonald

• Family Nurse Practitioner in Timonium, MD
• Providers in Timonium, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.