Erta Behavioral Health, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ERTA BEHAVIORAL HEALTH, LLC

Practice address

7400 Wilhelm Dr
Lanham, MD 20706-3725

Phone

(240) 501-2710

NPI assigned

Jan 24, 2020

Last updated

Jun 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jon Kogan

Title

Delegated Official

Phone

(443) 253-5533

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 3

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.

• Folasade Folake Iluyomade

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowie, MD
  • NPI 1245962430

  DC

  Medicare reassignment NPD
• Kimberly Johnson, LCPC

  • Professional Counselor
  • Columbia, MD
  • NPI 1407340185

  DC

  Medicare reassignment NPD
• Renata Bebongnchu Nkeze, NP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Lanham, MD
  • NPI 1689925497

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1487284816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 WILHELM DR",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063725",
            "telephone_number": "240-501-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 WILHELM DR",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063725",
            "telephone_number": "240-501-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERTA BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "KOGAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "443-253-5533"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Epperson
• Mary Aso Epse Anu Acha
• Collette Kewae Epse Fonzenyuy
• Kevin Erfan, M.D
• Awambeng Eric
• Ashley Ambo Esibe
• Brianne Esolen
• Heidi Esong
• Esram Medicare Risk Assessment Consulting Firm LLC
• Essential Home Care Services LLC

• Psychiatric/Mental Health Nurse Practitioner in Lanham, MD
• Providers in Lanham, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.