NPIMap

Organization Active NPI

His &Her Medical and Mental Health Services

  • Family Nurse Practitioner
  • Oxon Hill, MD
National Provider Identifier
1497428882
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HIS &HER MEDICAL AND MENTAL HEALTH SERVICES
Practice address
6196 Oxon Hill Rd Ste 290
Oxon Hill, MD 20745-3141
Phone
(240) 493-7847
NPI assigned
Jul 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Authorized official

Name
Efemwonyi F Jesuorobo, DNP, CRNP, FNP,PMHNPNPI 1760835003
Title
Owner of the Entity
Phone
(240) 493-7847

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

6196 Oxon Hill Rd Ste 290
Oxon Hill, MD 20745-3141

Mailing address

6196 Oxon Hill Rd Ste 290
Oxon Hill, MD 20745-3141
Phone (240) 493-7847

Other names 1

  • MEDICAL & MENTAL HEALTH PROVIDER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210824000669 DC Part B Supplier - Clinic/Group Practice 6002211406 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oxon Hill, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
His Her Medical and Mental Health Servi2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1497428882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6196 OXON HILL RD STE 290",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453141",
            "telephone_number": "240-493-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6196 OXON HILL RD STE 290",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453141",
            "telephone_number": "240-493-7847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIS &HER MEDICAL AND MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "JESUOROBO",
        "authorized_official_first_name": "EFEMWONYI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER OF THE ENTITY",
        "authorized_official_telephone_number": "240-493-7847",
        "authorized_official_credential": "DNP, CRNP, FNP,PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL & MENTAL HEALTH PROVIDER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oxon Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.