Individual provider Active NPI

Maria Harrison-Nwachukwu

  • Psychiatric/Mental Health Nurse Practitioner
  • Lanham, MD
National Provider Identifier
1477014538
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R200532 Issued in MD
Practice address
9103 Woodmore Center Dr # 412
Lanham, MD 20706-1653
Phone
(240) 361-9242
NPI assigned
Mar 29, 2019
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R200532 MD Primary

Addresses

Primary practice location

9103 Woodmore Center Dr # 412
Lanham, MD 20706-1653

Mailing address

9103 Woodmore Center Dr # 412
Lanham, MD 20706-1653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191122000650 MD Practitioner - Nurse Practitioner 7618208687 Reassigns benefits to 1 organization
I20191210000444 DC Practitioner - Nurse Practitioner 7618208687 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Inspire Behavioral Health Care LLC Psychiatric/Mental Health CurrentSince Jan 8, 2021 Accepting new patients

Locations

9103 Woodmore Center Dr
Lanham, MD 20706
Phone (240) 361-9242

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1477014538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9103 WOODMORE CENTER DR # 412",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207061653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9103 WOODMORE CENTER DR # 412",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207061653",
            "telephone_number": "240-361-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON-NWACHUKWU",
        "first_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R200532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.