Mohamed Bundu

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

174442 Issued in MD

Practice address

50 Irving St NW
Washington, DC 20422-3317

Phone

(202) 745-8695

NPI assigned

Nov 15, 2015

Last updated

Jan 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1447545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1376917385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 ROSE MOUNT LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211878",
            "telephone_number": "301-808-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "204223317",
            "telephone_number": "202-745-8695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 I St SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200033317",
            "country_code": "US",
            "telephone_number": "202-484-6242",
            "fax_number": "202-484-6243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Mt Olivet Rd NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200022210",
            "country_code": "US",
            "telephone_number": "202-576-8388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNDU",
        "first_name": "MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-15",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R174442",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "174442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bumed
• Elizabeth Bumpas
• Abie A Bundu Sama
• Fatima Mariama Bundu-Kargbo
• Abibatu Bundu, R.N
• Camille Bundy
• Kamille Bundy
• Vanessa Bundy, MD, PHD
• Brunhilda Yedmia Bungwa
• Kehbuma Bungwa

• Psychiatric/Mental Health Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Psychiatric/Mental Health Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.