Active NPI
Miracle Healthcare and Wellness Center LLC
- Primary Care Nurse Practitioner
- Waldorf, MD
National Provider Identifier
1336052869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- MIRACLE HEALTHCARE AND WELLNESS CENTER LLC
- Practice address
- 2408 Plenty Gates LN # a
Waldorf, MD 20601-5602 - Phone
- (130) 161-3696
- NPI assigned
- Sep 25, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Toyin Mary Ajayi, DNP,FNP-BC
- Title
- Ceo
- Phone
- (301) 613-6963
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
2408 Plenty Gates LN # a
Waldorf, MD 20601-5602
Mailing address
2408 Plenty Gates LN # a
Waldorf, MD 20601-5602
Phone (130) 161-3696
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Glenn Dale, MD
- NPI 1811560279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790294400000",
"number": "1336052869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2408 PLENTY GATES LN # A",
"city": "WALDORF",
"state": "MD",
"postal_code": "206015602",
"telephone_number": "130-161-3696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2408 PLENTY GATES LN # A",
"city": "WALDORF",
"state": "MD",
"postal_code": "206015602",
"telephone_number": "130-161-3696"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIRACLE HEALTHCARE AND WELLNESS CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-25",
"last_updated": "2026-09-25",
"certification_date": "2026-09-25",
"status": "A",
"authorized_official_last_name": "AJAYI",
"authorized_official_first_name": "TOYIN",
"authorized_official_middle_name": "MARY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "301-613-6963",
"authorized_official_credential": "DNP,FNP-BC"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.