NPIMap

Organization Active NPI

Psychnp Wellness Center, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Towson, MD
National Provider Identifier
1184042004
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R114531 Issued in MD
Legal business name
PSYCHNP WELLNESS CENTER, LLC
Practice address
658 Kenilworth Drive
Suite 206
Towson, MD 21204
Phone
(410) 321-1388
Fax
(410) 321-9314
NPI assigned
Mar 29, 2014
Last updated
Mar 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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

Authorized official

Name
Ms. Teri A Murtha, PMHNP,CNS-BCNPI 1639320302
Title
Owner
Phone
(410) 321-1388

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X R114531 MD Primary

Addresses

Primary practice location

658 Kenilworth Drive
Suite 206
Towson, MD 21204

Mailing address

658 Kenilworth Drive
Suite 206
Towson, MD 21204
Phone (410) 321-1388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140617000765 MD Part B Supplier - Clinic/Group Practice 5890919625 Receives reassigned benefits from 21 practitioners
Practice locations: Columbia, MD; Towson, MD

National Provider Directory

National Provider Directory

Locations

5840 Banneker Rd
Ste 201
Columbia, MD 21044
Phone (443) 841-7550

658 Kenilworth Dr
Ste 206
Towson, MD 21204
Phone (410) 828-3585

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19068/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396051200000",
    "number": "1184042004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 KENILWORTH DRIVE",
            "address_2": "SUITE 206",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "410-321-1388",
            "fax_number": "410-321-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 KENILWORTH DRIVE",
            "address_2": "SUITE 206",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "410-321-1388",
            "fax_number": "410-321-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHNP WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-29",
        "last_updated": "2014-03-29",
        "status": "A",
        "authorized_official_last_name": "MURTHA",
        "authorized_official_first_name": "TERI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-321-1388",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHNP,CNS-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R114531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.