Gladys Varim Tebong Nee Ngwanyi

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AG09220100 Issued in MD

Practice address

10110 Molecular Dr Ste 114
Rockville, MD 20850-7538

Phone

(301) 780-4745

Fax

(301) 605-7550

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gladys.tebongneengwanyi@mmgi.gwaydirect.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.608025

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.

• Maryland Medical Group, Inc

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1467173203

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1508580697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10110 MOLECULAR DR STE 114",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507538",
            "telephone_number": "301-780-4745",
            "fax_number": "301-605-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 MOLECULAR DR STE 114",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507538",
            "telephone_number": "301-780-4745",
            "fax_number": "301-605-7550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9908 Maple Leaf Dr",
            "address_purpose": "LOCATION",
            "city": "Montgomery Village",
            "state": "MD",
            "postal_code": "208861134",
            "country_code": "US",
            "telephone_number": "240-515-6212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9908 Maple Leaf Dr",
            "address_purpose": "LOCATION",
            "city": "Montgomery Village",
            "state": "MD",
            "postal_code": "208861134",
            "country_code": "US",
            "telephone_number": "240-515-6212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEBONG NEE NGWANYI",
        "first_name": "GLADYS",
        "middle_name": "VARIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2024-04-25",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "AG09220100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tea Spa Wellness LLC
• Emily Teague
• Emily Teague
• Karen Teal
• Tamiya Teberen
• Julie Lynn Tebor, CRNP
• Sofia Tedesco, DC
• Aaron Tedla
• Enanu Mehari Tedla
• Adonay Eyesus Tefera

• Primary Care Nurse Practitioner in Rockville, MD
• Providers in Rockville, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.