Individual provider Active NPI

Edith Emelife, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Springdale, MD
National Provider Identifier
1295389930
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R200399 Issued in MD
Practice address
9513 Stoney Ridge Rd
Springdale, MD 20774-5441
Phone
(240) 381-5413
NPI assigned
Jul 31, 2019
Last updated
Jul 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R200399 MD Primary

Addresses

Primary practice location

9513 Stoney Ridge Rd
Springdale, MD 20774-5441

Mailing address

9513 Stoney Ridge Rd
Springdale, MD 20774-5441
Phone (240) 381-5413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200302000199 MD Practitioner - Nurse Practitioner 1557798691 Reassigns benefits to 1 organization
I20200325000196 DC Practitioner - Nurse Practitioner 1557798691 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Five Star Physician Services, LLC CurrentSince Feb 1, 2020 Accepting new patients
CTG LLC CurrentSince Oct 15, 2022 Accepting new patients
Beacon Health & Wellness Services LLC Family Current Accepting new patients

Locations

8700 Jones Mill Rd
Chevy Chase, MD 20815
Phone (301) 350-5555

785 Elkridge Landing Rd
Ste 300
Linthicum Heights, MD 21090
Phone (443) 323-3014

11810 Grand Park Ave
Ste 500
Rockville, MD 20852
Phone (301) 276-5468

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1295389930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9513 STONEY RIDGE RD",
            "city": "SPRINGDALE",
            "state": "MD",
            "postal_code": "207745441",
            "telephone_number": "240-381-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9513 STONEY RIDGE RD",
            "city": "SPRINGDALE",
            "state": "MD",
            "postal_code": "207745441",
            "telephone_number": "240-381-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMELIFE",
        "first_name": "EDITH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R200399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, MD

Sources for this page

Verify at the official NPI Registry.