Individual provider Active NPI

Solange N Missibi, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowie, MD
National Provider Identifier
1174886931
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP1025932 Issued in DC
Practice address
2508 Didcot CT
Bowie, MD 20721-2978
Phone
(301) 272-5100
Fax
(202) 920-1223
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1025932 DC
Home Health Aide 374U00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP1025932 DC Primary

Addresses

Primary practice location

2508 Didcot CT
Bowie, MD 20721-2978

Mailing address

2508 Didcot CT
Bowie, MD 20721-2978
Phone (301) 272-5100

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
I20240410003654 DC Practitioner - Nurse Practitioner 1052755063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psi Services III, Inc 8 clinicians

Practice addresses (Care Compare)

4645 Nannie Helen Burroughs Ave NE
Washington, DC 20019-3622
Phone (301) 272-5100

5820 Dix St NE
Washington, DC 20019-6965
Phone (202) 547-3870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1025932DCMDRegistered Nurse
NP1025932DCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sounique Health Services LLC Psychiatric/Mental Health CurrentSince Jul 22, 2024 Accepting new patients
Psi Services III, Inc. CurrentSince Mar 14, 2024 Accepting new patients
Turning Point Interventions, LLC Past Accepting new patients

Locations

4645 Nannie Helen Burroughs Ave NE
Washington, DC 20019
Phone (202) 733-4904

5820 Dix St NE
Washington, DC 20019
Phone (202) 276-2376

8301 Professional Pl
Ste 205
Hyattsville, MD 20785
Phone (240) 470-4098

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1174886931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 DIDCOT CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212978",
            "telephone_number": "301-272-5100",
            "fax_number": "202-920-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 DIDCOT CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212978",
            "telephone_number": "301-272-5100",
            "fax_number": "202-920-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSIBI",
        "first_name": "SOLANGE",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "1025932",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "NP1025932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.