Active NPI
Fatai Muritala
- Psychiatric/Mental Health Nurse Practitioner
- Bowie, MD
National Provider Identifier
1417847948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- R244123
- Practice address
- 10605 Heather Glen Way
Bowie, MD 20720-4280 - Phone
- (240) 413-3117
- NPI assigned
- Jul 7, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R244123 | MD | Primary |
Addresses
Primary practice location
10605 Heather Glen Way
Bowie, MD 20720-4280
Mailing address
10605 Heather Glen Way
Bowie, MD 20720-4280
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R244123 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751846400000",
"number": "1417847948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10605 HEATHER GLEN WAY",
"city": "BOWIE",
"state": "MD",
"postal_code": "207204280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10605 HEATHER GLEN WAY",
"city": "BOWIE",
"state": "MD",
"postal_code": "207204280",
"telephone_number": "240-413-3117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURITALA",
"first_name": "FATAI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-07-07",
"last_updated": "2025-07-07",
"certification_date": "2025-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MD",
"license": "R244123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.