Merj Community Healthcare Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MERJ COMMUNITY HEALTHCARE SERVICES LLC

Practice address

4407 Saddle River Dr
Bowie, MD 20720-3440

Phone

(240) 338-0226

NPI assigned

Nov 15, 2021

Organization subpart

No

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

Authorized official

Name

Bern M Simo Mukam, CRNP-PMHNP

Title

Owner

Phone

(240) 338-0226

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1255097150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4407 SADDLE RIVER DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203440",
            "telephone_number": "240-338-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 SADDLE RIVER DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203440",
            "telephone_number": "240-338-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERJ COMMUNITY HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "SIMO MUKAM",
        "authorized_official_first_name": "BERN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-338-0226",
        "authorized_official_credential": "CRNP-PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.