Individual provider Active NPI

Sandra C Anoruo, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Catonsville, MD
National Provider Identifier
1306497870
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R217264 Issued in MD
Practice address
516 N Rolling Rd
Catonsville, MD 21228-4140
Phone
(443) 929-5373
NPI assigned
Sep 25, 2019
Last updated
Sep 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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 R217264 MD Primary

Addresses

Primary practice location

516 N Rolling Rd
Catonsville, MD 21228-4140

Mailing address

516 N Rolling Rd
Catonsville, MD 21228-4140

Other names 1

  • Sandra C Elijah Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20191206001380 MD Practitioner - Nurse Practitioner 6901239888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowering Minds Resource CenterGroup PAC ID 2062821929, 3 clinicians

Practice addresses (Care Compare)

1800 N Charles St
Suite 600
Baltimore, MD 21201-5990
Phone (443) 379-3852

7954 Baltimore Annapolis Blvd
Suite 2E
Glen Burnie, MD 21060-8187
Phone (410) 363-3713

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R217264MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Mobile Treatment Associates Inc Past Accepting new patients

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, 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": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1306497870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 N ROLLING RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 N ROLLING RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284140",
            "telephone_number": "443-929-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANORUO",
        "first_name": "SANDRA",
        "middle_name": "C",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R217264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "ELIJAH",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Catonsville, MD

Sources for this page

Verify at the official NPI Registry.