Individual provider Active NPI

Kumutha Flawrence Daniel, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Largo, MD
National Provider Identifier
1225627136
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R187115 Issued in MD
Practice address
1401 Mercantile LN Ste 200H
Largo, MD 20774-4310
Phone
(301) 957-5451
Fax
(301) 281-4002
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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 R187115 MD Primary

Addresses

Primary practice location

1401 Mercantile LN Ste 200H
Largo, MD 20774-4310

Mailing address

1401 Mercantile LN Ste 200H
Largo, MD 20774-4310
Phone (301) 957-5451

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
I20210513002188 DC Practitioner - Nurse Practitioner 3173932670 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MD Behavioral Health LLC 12 clinicians
Integrated Behavioral Health, LLC 3 clinicians

Practice addresses (Care Compare)

12907 Northampton Dr
Beltsville, MD 20705-6333
Phone (240) 507-0015

4000 Mitchellville Rd
Suite A414
Bowie, MD 20716-3142
Phone (301) 249-8100

4200 Forbes Blvd
Suite 110
Lanham, MD 20706-4374
Phone (301) 499-4240

Merit-based Incentive Payment System (MIPS)

Final score
25.78 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
85.93

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bowie Town Behavioral Services, Inc CurrentSince Jan 8, 2022 Accepting new patients
Premier Health Care, LLC CurrentSince May 1, 2021 Accepting new patients
Premier Health Care LLC CurrentSince May 1, 2021 Accepting new patients
MD Behavioral Health LLC CurrentSince Feb 18, 2024 Accepting new patients
Integrated Behavioral Health, LLC CurrentSince Dec 1, 2023 Accepting new patients
Peaceful Mind Behavioral Health LLC Psychiatric/Mental Health CurrentSince Feb 1, 2025 Accepting new patients
Premier Health Care LLC Past Accepting new patients

Locations

4000 Mitchellville Rd
Ste A414
Bowie, MD 20716
Phone (301) 249-8100

14999 Health Center Dr
Ste 202
Bowie, MD 20716
Phone (301) 218-4220

4200 Forbes Blvd
Ste 110
Lanham, MD 20706
Phone (202) 607-6932

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

Organizations & group practices 7

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": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1225627136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 200H",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744310",
            "telephone_number": "301-957-5451",
            "fax_number": "301-281-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 200H",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744310",
            "telephone_number": "301-957-5451",
            "fax_number": "301-281-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "KUMUTHA",
        "middle_name": "FLAWRENCE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R187115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.