NPIMap

Organization Active NPI

Mem Scepter Home & Behavioral

Doing business as Mem Scepter Home & Behavioral Health Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Leonardtown, MD
National Provider Identifier
1407462559
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MEM SCEPTER HOME & BEHAVIORAL
Doing business as
Mem Scepter Home & Behavioral Health Care LLC
Practice address
25484 Point Lookout Rd Ste 301a
Leonardtown, MD 20650-3842
Phone
(240) 309-4111
Fax
(240) 309-4095
NPI assigned
Sep 23, 2020
Last updated
Jun 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Modupe O Adenekan, PMHNPNPI 1790340859
Title
President
Phone
(202) 449-0001

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

25484 Point Lookout Rd Ste 301a
Leonardtown, MD 20650-3842

Mailing address

14104 Dawn Whistle Way
Bowie, MD 20721-1304
Phone (202) 449-0001

Other names 1

  • Mem Scepter Home & Behavioral Health Care LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201209000068 MD Part B Supplier - Clinic/Group Practice 1355753765 Receives reassigned benefits from 4 practitioners
Practice locations: Leonardtown, MD

National Provider Directory

National Provider Directory
Tax ID family
Mem Scepter Home Behavioral4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

25484 Point Lookout Rd
Ste 301
Leonardtown, MD 20650
Phone (202) 449-0001

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1407462559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14104 DAWN WHISTLE WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211304",
            "telephone_number": "202-449-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25484 POINT LOOKOUT RD STE 301A",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503842",
            "telephone_number": "240-309-4111",
            "fax_number": "240-309-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEM SCEPTER HOME & BEHAVIORAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "ADENEKAN",
        "authorized_official_first_name": "MODUPE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-449-0001",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mem Scepter Home & Behavioral Health Care LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mem Scepter Home & Behavioral Health Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.