Individual provider Active NPI

Ayah Mumah Taniform, NP

  • Family Nurse Practitioner
  • Upper Marlboro, MD
National Provider Identifier
1134598055
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R190176 Issued in MD
Practice address
10600 Melwood Chapel LN
Upper Marlboro, MD 20772-2960
Phone
(240) 646-2242
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R190176 MD Primary

Addresses

Primary practice location

10600 Melwood Chapel LN
Upper Marlboro, MD 20772-2960

Mailing address

3499 Fort Meade Rd Apt 2
Laurel, MD 20724-2063

Other names 1

  • Honorine Ayah Mumah Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201211000672 DC Practitioner - Nurse Practitioner 2466864640 Reassigns benefits to 1 organization
I20250327003613 MD Practitioner - Nurse Practitioner 2466864640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Juniper Healthcare LLCGroup PAC ID 1355648064, 6 clinicians

Practice addresses (Care Compare)

14200 Laurel Park Dr
Laurel, MD 20707-5201
Phone (410) 465-7850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R190176MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Juniper Healthcare LLC CurrentSince Dec 1, 2020 Accepting new patients
Kurup Wound Care, Inc. Family Medicine CurrentSince May 19, 2021 Accepting new patients

Locations

6116 Belair Rd
Baltimore, MD 21206
Phone (410) 426-1424

9055 Chevrolet Dr
Ste 103
Ellicott City, MD 21042
Phone (443) 355-6290

12021 Livingston Rd
Ft Washington, MD 20744
Phone (301) 292-0300

1835 University Blvd E
Ste 208
Hyattsville, MD 20783
Phone (301) 445-3501

4922 Lasalle Rd
Hyattsville, MD 20782
Phone (301) 445-3501

14200 Laurel Park Dr
Laurel, MD 20707
Phone (301) 953-7980

Organizations & group practices 2

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": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1134598055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3499 FORT MEADE RD APT 2",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207242063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 MELWOOD CHAPEL LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722960",
            "telephone_number": "240-646-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANIFORM",
        "first_name": "AYAH",
        "middle_name": "MUMAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R190176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HONORINE",
            "last_name": "MUMAH",
            "middle_name": "AYAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Upper Marlboro, MD

Sources for this page

Verify at the official NPI Registry.