NPIMap

Organization Active NPI

Nu Pathway Healthcare and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Denton, MD
National Provider Identifier
1114632072
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
NU PATHWAY HEALTHCARE AND WELLNESS LLC
Practice address
520 Kerr Ave
Denton, MD 21629-1343
Phone
(301) 321-7741
Fax
(301) 291-7071
NPI assigned
Jan 16, 2023
Last updated
Jan 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
Owen Gardner
Title
Owner
Phone
(301) 928-4725

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

520 Kerr Ave
Denton, MD 21629-1343

Mailing address

14300 Gallant Fox LN Ste 202
Bowie, MD 20715-4033
Phone (301) 321-7741

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220113001074 MD Part B Supplier - Clinic/Group Practice 9830529585 Receives reassigned benefits from 8 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chestertown, MD; Columbia, MD

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1114632072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 GALLANT FOX LN STE 202",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154033",
            "telephone_number": "301-321-7741",
            "fax_number": "301-291-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 KERR AVE",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291343",
            "telephone_number": "301-321-7741",
            "fax_number": "301-291-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NU PATHWAY HEALTHCARE AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "OWEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-928-4725"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.