Marie Fayette Charles, CRNP-FNP-PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R221196 Issued in MD

Practice address

3261 Old Washington Rd Ste 2020
Waldorf, MD 20602-3231

Phone

(240) 419-2412

Fax

(240) 366-5753

NPI assigned

Mar 29, 2018

Last updated

Jan 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

National Capital Treatment and RecoveryGroup PAC ID 2567807647, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• National Capital Treatment and Recovery

  • Substance Abuse Rehabilitation Facility
  • Arlington, VA
  • NPI 1558415968

  DC, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Edcha Behavioral Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Waldorf, MD
  • NPI 1245745918
  Medicare reassignment NPD
• National Capital Treatment and Recovery-Maryland

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
  • NPI 1528740628

  Family

  NPD
• HCR Manorcare Medical Services of Florida LLC

  dba Heartland Care Partners

  • Nurse Practitioner
  • Toledo, OH
  • NPI 1386750420
  NPD

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1376048348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD STE 2020",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023231",
            "telephone_number": "240-419-2412",
            "fax_number": "240-366-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD STE 2020",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023231",
            "telephone_number": "240-419-2412",
            "fax_number": "240-366-5753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4669 Falls Rd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212094914",
            "country_code": "US",
            "telephone_number": "800-427-1902",
            "fax_number": "800-564-5952",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2670 Crain Hwy Ste 510",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206012819",
            "country_code": "US",
            "telephone_number": "240-416-6836",
            "fax_number": "240-292-4170",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1554 Columbia Pike",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222044667",
            "country_code": "US",
            "telephone_number": "703-649-8014",
            "fax_number": "703-228-0028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MARIE",
        "middle_name": "FAYETTE",
        "name_prefix": "Mrs.",
        "credential": "CRNP-FNP-PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180406",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R221196",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024180406",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R221196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601507691",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911012700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Porcelain Chae
• Embarka Chaib
• Jamilah Chambers
• Charles Care Pharmacy LLC (Anchor Pharmacy)
• Edner Charles, PMHNP-BC
• Charleston Grove, LLC (The Charleston Senior Community)
• Charm City Orthotics & Prosthetics
• Mansi Chavan
• Manisha K Chawla
• Love Ngum Che, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.