Individual provider Active NPI

Joy Chyddy Umeobi

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowie, MD
National Provider Identifier
1346832649
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN194450 Issued in MD
Practice address
12222 Kingswell St
Bowie, MD 20721-1952
Phone
(240) 393-6770
NPI assigned
Feb 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X RN194450 MD Primary

Addresses

Primary practice location

12222 Kingswell St
Bowie, MD 20721-1952

Mailing address

12222 Kingswell St
Bowie, MD 20721-1952
Phone (240) 393-6770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN194450MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group LLC Single Specialty CurrentSince Jun 3, 2023 Accepting new patients
Supportive Care of Maryland LLC Single Specialty CurrentSince Jun 22, 2021 Accepting new patients
Care Now Clinic LLC Single Specialty CurrentSince Apr 13, 2021 Accepting new patients

Locations

6310 Stevens Forest Rd
Columbia, MD 21046
Phone (410) 740-3240

6310 Stevens Forest Rd
Ste 200
Columbia, MD 21046
Phone (410) 245-2414

9318 Gaither Rd
Ste 245
Gaithersburg, MD 20877
Phone (301) 367-1533

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1346832649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12222 KINGSWELL ST",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211952",
            "telephone_number": "240-393-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 KINGSWELL ST",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211952",
            "telephone_number": "240-393-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMEOBI",
        "first_name": "JOY",
        "middle_name": "CHYDDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "RN194450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.