Individual provider Active NPI

Chioma Calista Uzoma, PMHNP - BC

  • Psychiatric/Mental Health Registered Nurse
  • Baltimore, MD
National Provider Identifier
1164012795
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
R221556 Issued in MD
Practice address
4002 W Belvedere Ave Unit a
Baltimore, MD 21215-5502
Phone
(443) 743-5998
NPI assigned
Jan 18, 2021
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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 Registered Nurse 163WP0808X R221556 MD Primary

Addresses

Primary practice location

4002 W Belvedere Ave Unit a
Baltimore, MD 21215-5502

Mailing address

3732 Seneca Garden Rd
Baltimore, MD 21220-7517
Phone (443) 743-5998

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
I20210826002333 MD Practitioner - Nurse Practitioner 0143625251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chimark Healthcare Services LLCGroup PAC ID 9739569617, 2 clinicians

Practice addresses (Care Compare)

3732 Seneca Garden Rd
Middle River, MD 21220-7517
Phone (443) 743-5998

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R221556MDMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Chimark Healthcare Services LLC CurrentSince Jun 15, 2022 Accepting new patients
Excellent Healthcare & Psychiatric Rehabilitation Program Services Inc CurrentSince Jul 5, 2021 Accepting new patients
Excellent Healthcare & Psychiatric Rehabilitation Program Services Inc CurrentSince Jul 5, 2021 Accepting new patients

Locations

4002 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 304-6544

4002 W Belvedere Ave
#A
Baltimore, MD 21215
Phone (410) 984-7411

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1164012795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3732 SENECA GARDEN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212207517",
            "telephone_number": "443-743-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 W BELVEDERE AVE UNIT A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155502",
            "telephone_number": "443-743-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UZOMA",
        "first_name": "CHIOMA",
        "middle_name": "CALISTA",
        "credential": "PMHNP - BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-08-02",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R221556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.