Obiageli Duru Anoumatacky, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R193298 Issued in MD

Practice address

19735 Germantown Rd
Germantown, MD 20874-1214

Phone

(301) 634-9600

Fax

(301) 493-8553

NPI assigned

May 14, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Obiageli Littlejohn Former name

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Montgomery County Maryland GovernmentGroup PAC ID 4981675477, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: obiageli.duruanoumatcky.p1@direct.mcg-hhs.nextgenshare.com

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.

• Montgomery County Maryland Government

  • Adult Mental Health Clinic/Center
  • Silver Spring, MD
  • NPI 1104946482

  DC

  Medicare reassignment Care Compare group NPD
• Montgomery County Maryland Government

  • Community/Behavioral Health Agency
  • Rockville, MD
  • NPI 1326939570
  NPD
• Montgomery County Maryland Government

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockville, MD
  • NPI 1669225868
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1508244161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9309 OLD GEORGETOWN RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141620",
            "telephone_number": "301-634-9600",
            "fax_number": "301-493-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19735 GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741214",
            "telephone_number": "301-634-9600",
            "fax_number": "301-493-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURU ANOUMATACKY",
        "first_name": "OBIAGELI",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1022296",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R193298",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R193298",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "1022296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OBIAGELI",
            "last_name": "LITTLEJOHN",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Ayanha Aquilla Dyson, MSW
• Eleanor Dzodzomenyo, CRNP, FNP-BC
• Senam Dzodzomenyo
• Robert Eagen
• Eaman Physical Therapy, LLC

• Family Nurse Practitioner in Germantown, MD
• Providers in Germantown, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.