Individual provider Active NPI

Darlington Nwoke Uchechukwu

  • Family Nurse Practitioner
  • Glenn Dale, MD
National Provider Identifier
1487474995
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R199886 Issued in MD
Practice address
12150 Annapolis Rd Ste 100
Glenn Dale, MD 20769-9183
Phone
(301) 464-7601
Fax
(866) 885-9817
NPI assigned
Oct 10, 2024
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R199886 MD Primary

Addresses

Primary practice location

12150 Annapolis Rd Ste 100
Glenn Dale, MD 20769-9183

Mailing address

12150 Annapolis Rd Ste 100
Glenn Dale, MD 20769-9183
Phone (301) 464-7601

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250226000260 DC Practitioner - Nurse Practitioner 1951821594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Krystal Medical Associates LLCGroup PAC ID 8426247339, 3 clinicians

Practice addresses (Care Compare)

12150 Annapolis Rd
Suite 100
Glenn Dale, MD 20769-9183
Phone (301) 464-7601

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Krystal Medical Associates LLC CurrentSince Dec 26, 2024 Accepting new patients

Locations

12150 Annapolis Rd
Ste 100
Glenn Dale, MD 20769
Phone (301) 464-7601

Organizations & group practices 1

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": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1487474995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD STE 100",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "301-464-7601",
            "fax_number": "866-885-9817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD STE 100",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "301-464-7601",
            "fax_number": "866-885-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UCHECHUKWU",
        "first_name": "DARLINGTON",
        "middle_name": "NWOKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R199886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenn Dale, MD

Sources for this page

Verify at the official NPI Registry.