NPIMap

Organization Active NPI

Krissey Medical and Mental Health

  • Family Nurse Practitioner
  • Bowie, MD
National Provider Identifier
1336964964
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
KRISSEY MEDICAL AND MENTAL HEALTH
Practice address
10111 Martin Luther King Jr Hwy Ste 101
Bowie, MD 20720-4231
Phone
(248) 470-3427
Fax
(240) 334-2558
NPI assigned
Nov 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Authorized official

Name
Christiana RobertsNPI 1558805333
Title
Owner
Phone
(202) 546-7696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

10111 Martin Luther King Jr Hwy Ste 101
Bowie, MD 20720-4231

Mailing address

10111 Martin Luther King Jr Hwy Ste 101
Bowie, MD 20720-4231
Phone (248) 470-3427

National Provider Directory

National Provider Directory
Tax ID family
Krissey Medical and Mental Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10111 Mlk Hwy
Ste 200A
Bowie, MD 20720
Phone (248) 470-3427

10111 Mlk Hwy
Ste 101
Bowie, MD 20720
Phone (240) 474-8214

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1336964964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 MARTIN LUTHER KING JR HWY STE 101",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204231",
            "telephone_number": "248-470-3427",
            "fax_number": "240-334-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10111 MARTIN LUTHER KING JR HWY STE 101",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204231",
            "telephone_number": "248-470-3427",
            "fax_number": "240-334-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISSEY MEDICAL AND MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "CHRISTIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-546-7696"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.