Envisioncare Medical Associates, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

NP117688 Issued in MD

Legal business name

ENVISIONCARE MEDICAL ASSOCIATES, LLC

Practice address

10507 Montana Ter
Upper Marlboro, MD 20774-6034

Phone

(301) 237-7383

Fax

(301) 322-9555

NPI assigned

Jul 31, 2008

Organization subpart

No

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

Authorized official

Name

Chinwe N Ndubisi, MSN, CRNP-F, ARNP-FNPI 1770745184

Title

Medical Practitioner

Phone

(301) 237-7383

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

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

• Chinwe N. Ndubisi, APRN, CRNP-F, PH.D

  • Family Nurse Practitioner
  • Largo, MD
  • NPI 1770745184

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1578729331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LN",
            "address_2": "SUITE 124",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745341",
            "telephone_number": "301-322-9292",
            "fax_number": "301-322-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10507 MONTANA TER",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207746034",
            "telephone_number": "301-237-7383",
            "fax_number": "301-322-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISIONCARE MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-31",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "NDUBISI",
        "authorized_official_first_name": "CHINWE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MEDICAL PRACTITIONER",
        "authorized_official_telephone_number": "301-237-7383",
        "authorized_official_credential": "MSN, CRNP-F, ARNP-F"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": "NP117688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-CMS",
            "identifier": "1770745184",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pamela Awu Enyong
• Epic Home Health Services LLC

• Clinic/Center in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.