Individual provider Active NPI

Augusta Nnawuba

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Washington, MD
National Provider Identifier
1184323669
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R188085 Issued in MD
Practice address
10903 Indian Head Hwy Ste 504
Fort Washington, MD 20744-4012
Phone
(240) 467-0628
NPI assigned
Feb 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X R188085 MD Primary

Addresses

Primary practice location

10903 Indian Head Hwy Ste 504
Fort Washington, MD 20744-4012

Mailing address

9110 Glenarden Pkwy
Glenarden, MD 20706-2665
Phone (301) 395-1861

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
I20240605003502 DC Practitioner - Nurse Practitioner 1850833856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psi Services III, IncGroup PAC ID 1850464660, 8 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R188085MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psi Services III, Inc. Single Specialty CurrentSince Apr 29, 2024 Accepting new patients
Kenada Optimum Healthcare Services LLC Past Accepting new patients

Locations

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 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": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1184323669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9110 GLENARDEN PKWY",
            "city": "GLENARDEN",
            "state": "MD",
            "postal_code": "207062665",
            "telephone_number": "301-395-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10903 INDIAN HEAD HWY STE 504",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207444012",
            "telephone_number": "240-467-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNAWUBA",
        "first_name": "AUGUSTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R188085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, MD

Sources for this page

Verify at the official NPI Registry.