Organization Active NPI

New Era Wellness, LLC

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1528419561
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R157786 Issued in MD
Legal business name
NEW ERA WELLNESS, LLC
Doing business as
New Era Wellness
Practice address
5411 Old Frederick Rd Ste 2
Baltimore, MD 21229-2126
Phone
(410) 775-6394
NPI assigned
Jun 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Ms. Myrtis Marvell-McCain Agen-Davis, PMHNP-BC, FNP-CNPI 1386899961
Title
Family Nurse Practitioner
Phone
(410) 775-6394

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: 193400000X SINGLE SPECIALTY GROUP 363LF0000X R157786 MD Primary

Addresses

Primary practice location

5411 Old Frederick Rd Ste 2
Baltimore, MD 21229-2126

Mailing address

5411 Old Frederick Rd Ste 2
Baltimore, MD 21229-2126
Phone (410) 775-6394

Other identifiers 1

IdentifierTypeStateIssuer
056072300MedicaidMD

Other names 1

  • New Era Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160917000018 MD Part B Supplier - Clinic/Group Practice 0840587986 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Locations

715 Ingleside Ave
Catonsville, MD 21228
Phone (410) 960-2496

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": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1528419561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 OLD FREDERICK RD STE 2",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212292126",
            "telephone_number": "410-775-6394",
            "fax_number": "410-881-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 OLD FREDERICK RD STE 2",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212292126",
            "telephone_number": "410-775-6394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ERA WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "AGEN-DAVIS",
        "authorized_official_first_name": "MYRTIS",
        "authorized_official_middle_name": "MARVELL-MCCAIN",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "410-775-6394",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHNP-BC, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R157786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056072300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Era Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.