Fidelis Eghoateh Atianjoh, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN221785 Issued in MD

Practice address

1401 Mercantile LN Ste 200C
Upper Marlboro, MD 20774-4309

Phone

(301) 332-8886

NPI assigned

Aug 27, 2021

Last updated

Aug 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arundel Mental Health Professionals LCGroup PAC ID 4981688173, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.fidelisatianjoh@149037.advancedmd-direct.com

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.

• Arundel Mental Health Professionals L.C.

  dba LifeStance Health

  • Clinical Psychologist
  • Arnold, MD
  • NPI 1073649521

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Global Healthcare Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pikesville, MD
  • NPI 1003588955

  Single Specialty

  Medicare reassignment NPD
• Arundel Mental Health Professionals LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Annapolis, MD
  • NPI 1649906496
  NPD

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1396412243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 200C",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207744309",
            "telephone_number": "301-332-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 200C",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207744309",
            "telephone_number": "301-332-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIANJOH",
        "first_name": "FIDELIS",
        "middle_name": "EGHOATEH",
        "name_prefix": "Dr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "RN221785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optetius Nkenganji Atabong
• Agendia Mathew Atabongkeng
• Cyrian Atembe
• Afeh Atetakoh
• Ati Holding LLC (ATI Physical Therapy)
• Ezekiel Atiroko
• Atrium Health Care LLC
• Agbonluai Emmanuel Atta
• Protest Tifuh Atud
• Claudia Anu Atukwoh, LGSW

• Psychiatric/Mental Health Nurse Practitioner in Upper Marlboro, MD
• Providers in Upper Marlboro, 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 Aug 27, 2021; 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.