Individual provider Active NPI

Linda Nwachuku, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1174287627
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R223297 Issued in MD
Practice address
5718 Belair Rd
Baltimore, MD 21206-2603
Phone
(443) 447-3190
NPI assigned
Oct 29, 2021
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 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 Nurse Practitioner 363LP0808X R223297 MD Primary

Addresses

Primary practice location

5718 Belair Rd
Baltimore, MD 21206-2603

Mailing address

5718 Belair Rd
Baltimore, MD 21206-2603
Phone (443) 447-3190

Other practice location 1

40 S Dundalk Ave Ste 400
Baltimore, MD 21222-4273
Phone (410) 220-0720

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
I20220105000377 MD Practitioner - Nurse Practitioner 6204227036 Reassigns benefits to 2 organizations
Practice locations: Baltimore, MD

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

40 S Dundalk Ave
Suite 400
Dundalk, MD 21222-4273
Phone (410) 220-0720

8604 Harford Rd
Parkville, MD 21234-4612
Phone (410) 559-4307

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R223297MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matclinic Physicians Practice Group LLC Mental Health Current Accepting new patients
Vineyard Gentle Care LLC Current Accepting new patients
Matclinic Physicians Practice Group LLC Mental Health CurrentSince Dec 20, 2021 Accepting new patients

Locations

40 S Dundalk Ave
Ste 400
Dundalk, MD 21222
Phone (410) 220-0270

40 York Rd
Ste 201
Towson, MD 21204
Phone (410) 220-0780

Organizations & group practices 4

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": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1174287627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5718 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212062603",
            "telephone_number": "443-447-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5718 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212062603",
            "telephone_number": "443-447-3190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 S Dundalk Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212224273",
            "country_code": "US",
            "telephone_number": "410-220-0720",
            "fax_number": "410-862-0150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWACHUKU",
        "first_name": "LINDA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R223297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.