Individual provider Active NPI

Gideon Nyambiya, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1245969963
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R239528 Issued in MD
Practice address
7820B Wormans Mill Rd #326
Frederick, MD 21701
Phone
(240) 541-2790
NPI assigned
Jun 8, 2022
Last updated
Jun 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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 R239528 MD Primary

Addresses

Primary practice location

7820B Wormans Mill Rd #326
Frederick, MD 21701

Mailing address

1808 Derrs CT
Frederick, MD 21701-2519
Phone (240) 541-2790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R239528MDMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1245969963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 DERRS CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217012519",
            "telephone_number": "240-541-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7820B WORMANS MILL RD #326",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21701",
            "telephone_number": "240-541-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAMBIYA",
        "first_name": "GIDEON",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R239528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.