Individual provider Active NPI

Chinyere Lois Otuya, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Largo, MD
National Provider Identifier
1134482615
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R176612 Issued in MD
Practice address
1300 Mercantile LN Ste 100a
Largo, MD 20774-5383
Phone
(240) 906-2723
Fax
(703) 454-0722
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN1010504 DC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R176612 MD Primary

Addresses

Primary practice location

1300 Mercantile LN Ste 100a
Largo, MD 20774-5383

Mailing address

1611 Pebble Beach Dr
Bowie, MD 20721-2375
Phone (240) 462-9940

Other practice location 1

1629 K St NW Ste 300
Washington, DC 20006-1631
Phone (240) 906-2723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20200821001806 DC Practitioner - Nurse Practitioner 7911324884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1300 Mercantile LN
Suite 129 21
Upper Marlboro, MD 20774-5327
Phone (301) 250-4310

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1010504DCMDPsychiatric/Mental Health Nurse Practitioner
R176612MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guardian Angel Home Health Inc Current Accepting new patients
Guardian Angel Home Health, Inc CurrentSince Jan 13, 2022 Accepting new patients

Organizations & group practices 3

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1134482615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 PEBBLE BEACH DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212375",
            "telephone_number": "240-462-9940",
            "fax_number": "703-454-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN STE 100A",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745383",
            "telephone_number": "240-906-2723",
            "fax_number": "703-454-0722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1629 K St NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061631",
            "country_code": "US",
            "telephone_number": "240-906-2723",
            "fax_number": "703-454-0722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTUYA",
        "first_name": "CHINYERE",
        "middle_name": "LOIS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN1010504",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R176612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.