Marilyn Nah Ngundam, NP -C, PMHNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704312977 Issued in MI

Practice address

6309 Mack Ave
Detroit, MI 48207-2302

Phone

(313) 921-4700

NPI assigned

Nov 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Greenfield and 9 Mile Medical Center PLLC

  • Family Medicine Physician
  • Oak Park, MI
  • NPI 1265874945
  Medicare reassignment NPD
• VMD Primary Providers Eastern Michigan, PC

  • Family Medicine Physician
  • Novi, MI
  • NPI 1336625540
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MI, Psychiatric/Mental Health

  Medicare reassignment NPD
• Greenfield and 9 Mile Medical Center PLLC

  • Clinical Medical Laboratory
  • Southfield, MI
  • NPI 1598279804
  NPD
• MCTS Rose, LLC

  • Adult Mental Health Clinic/Center
  • Troy, MI
  • NPI 1588357461
  NPD

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1447720669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-921-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-921-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3950 S Rochester Rd Ste 1300",
            "address_purpose": "LOCATION",
            "city": "Rochester Hills",
            "state": "MI",
            "postal_code": "48307",
            "country_code": "US",
            "telephone_number": "248-705-6223",
            "fax_number": "248-253-1462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3950 S Rochester Rd Ste 1300",
            "address_purpose": "LOCATION",
            "city": "Rochester Hills",
            "state": "MI",
            "postal_code": "48307",
            "country_code": "US",
            "telephone_number": "248-705-6223",
            "fax_number": "248-253-1462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "66 W Flagler St Ste 900",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331301807",
            "country_code": "US",
            "telephone_number": "313-290-0632",
            "fax_number": "313-217-7662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N Wayne Rd",
            "address_purpose": "LOCATION",
            "city": "Westland",
            "state": "MI",
            "postal_code": "481853628",
            "country_code": "US",
            "telephone_number": "734-522-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1861 E Maple Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480834207",
            "country_code": "US",
            "telephone_number": "248-246-0172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "911 E 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Ferndale",
            "state": "MI",
            "postal_code": "482201934",
            "country_code": "US",
            "telephone_number": "248-336-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18463 Livernois Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482212254",
            "country_code": "US",
            "telephone_number": "313-861-5810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUNDAM",
        "first_name": "MARILYN",
        "middle_name": "NAH",
        "credential": "NP -C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704312977",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704312977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI STATE LICENSE",
            "identifier": "4704312977",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Shelby NG, RN
• Odette Aneng Ngalla
• Josephine Irukaego Ngama, MD
• Lenyie Ngbogbara
• Julie Ngo
• Nam Tran Nguyen Lam, DO
• Joseph Nguyen-Dinh
• Annie Phuong Thao Dinh Nguyen, PHARM.D., BCPS
• Felix Nguyen, MD
• Henry Nguyen, DO

• Family Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.