Individual provider Active NPI

Chika Okonkwo, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Glenarden, MD
National Provider Identifier
1114495876
Registry record updated Nov 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN1015758 Issued in DC
Practice address
2806 Hornbeam CT
Glenarden, MD 20706-5516
Phone
(301) 357-4053
NPI assigned
Nov 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X RN1015758 DC Primary

Addresses

Primary practice location

2806 Hornbeam CT
Glenarden, MD 20706-5516

Mailing address

2806 Hornbeam CT
Glenarden, MD 20706-5516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190404000847 MD Practitioner - Nurse Practitioner 6608117411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fore Counselling Health CentreGroup PAC ID 9234565300, 3 clinicians
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1010 Park Ave
Suite 103
Baltimore, MD 21201-5637
Phone (410) 624-7121

201 E University Pkwy
Baltimore, MD 21218-2829
Phone (410) 554-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1015758DCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Mar 17, 2019 Accepting new patients
Medstar Medical Group II LLC Single Specialty CurrentSince Mar 17, 2019 Accepting new patients
Fore Counselling Health Centre Past Accepting new patients
Fore Counselling Health Centre Past Accepting new patients
Fore Counselling Health Centre Past Accepting new patients
Fore Counselling Health Centre Past Accepting new patients

Locations

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1541808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541808000000",
    "number": "1114495876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 HORNBEAM CT",
            "city": "GLENARDEN",
            "state": "MD",
            "postal_code": "207065516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 HORNBEAM CT",
            "city": "GLENARDEN",
            "state": "MD",
            "postal_code": "207065516",
            "telephone_number": "301-357-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKONKWO",
        "first_name": "CHIKA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-10",
        "last_updated": "2018-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN1015758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenarden, MD

Sources for this page

Verify at the official NPI Registry.