Active NPI
New Era Wellness, LLC
- Family Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1528419561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R157786
- 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
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-C
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056072300 | Medicaid | MD |
Other names 1
- New Era Wellness
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Baltimore, MD
- NPI 1386899961
Family
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.