Organization Active NPI

Gabtel Health Care LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Edgewater, MD
National Provider Identifier
1417631433
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GABTEL HEALTH CARE LLC
Practice address
20 Mayo Rd Ste 201
Edgewater, MD 21037-1442
Phone
(240) 645-3674
NPI assigned
Jun 12, 2023
Organization subpart
Yes
Parent organization
GABTEL HEALTH CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Perpetua Nnenna Anthony, FNP/PMHNPNPI 1083142442
Title
Pmhnp
Phone
(240) 645-3674

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

20 Mayo Rd Ste 201
Edgewater, MD 21037-1442

Mailing address

11905 Frost Dr
Bowie, MD 20720-4430
Phone (240) 645-3674

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240415002103 MD Part B Supplier - Clinic/Group Practice 7911346648 Receives reassigned benefits from 1 practitioner
Practice locations: Edgewater, MD

National Provider Directory

National Provider Directory
Tax ID family
Gabtel Health Care LLC2 organizations share this tax ID, including this one
Part of
Gabtel Health Care LLC

Other organizations with this tax ID 1

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

Locations

20 Mayo Rd
Edgewater, MD 21037
Phone (410) 544-2500

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1417631433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11905 FROST DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204430",
            "telephone_number": "240-645-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MAYO RD STE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210371442",
            "telephone_number": "240-645-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GABTEL HEALTH CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GABTEL HEALTH CARE LLC",
        "enumeration_date": "2023-06-12",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "PERPETUA",
        "authorized_official_middle_name": "NNENNA",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "240-645-3674",
        "authorized_official_credential": "FNP/PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.