Individual provider Active NPI

Olivia Nguh, NP

  • Adult Health Nurse Practitioner
  • Silver Spring, MD
National Provider Identifier
1336409374
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R220892 Issued in MD
Practice address
11510 Georgia Ave Ste 111
Silver Spring, MD 20902-1958
Phone
(240) 758-1782
NPI assigned
May 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R220892 MD Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R220892 MD

Addresses

Primary practice location

11510 Georgia Ave Ste 111
Silver Spring, MD 20902-1958

Mailing address

520 Main St Apt 1205
Malden, MA 02148-3906
Phone (617) 767-1150

Other names 1

  • Olivia Nguh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20200421000801 DC Practitioner - Nurse Practitioner 9032549738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Medical ClinicGroup PAC ID 8921411422, 3 clinicians

Practice addresses (Care Compare)

7404 Executive PL
Suite 100
Lanham, MD 20706-6237
Phone (240) 758-1782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Clinic CurrentSince Dec 1, 2020 Accepting new patients

Locations

7404 Executive Pl
Ste 100
Lanham, MD 20706
Phone (240) 260-3827

11510 Georgia Ave
Ste 111
Wheaton, MD 20902
Phone (240) 758-1782

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1336409374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MAIN ST APT 1205",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021483906",
            "telephone_number": "617-767-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11510 GEORGIA AVE STE 111",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209021958",
            "telephone_number": "240-758-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUH",
        "first_name": "OLIVIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R220892",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R220892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "NGUH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.