Holystic Health Services LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

HOLYSTIC HEALTH SERVICES LLC

Practice address

7375 Executive PL Ste 400 #1001
Lanham, MD 20706-6232

Phone

(301) 683-8313

Fax

(859) 208-1326

NPI assigned

Jul 11, 2024

Last updated

Jul 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Betrand Ekenja, DNP, CRNPNPI 1790163830

Title

Ceo

Phone

(301) 683-8313

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Betrand A Ekenja, DNP, CRNP

  • Family Nurse Practitioner
  • Washington, DC
  • NPI 1790163830

  MD

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1588401145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7375 EXECUTIVE PL STE 400 #1001",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7375 EXECUTIVE PL STE 400 #1001",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066232",
            "telephone_number": "301-683-8313",
            "fax_number": "859-208-1326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6310 Stevens Forest Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210461036",
            "country_code": "US",
            "telephone_number": "301-683-8313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOLYSTIC HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "EKENJA",
        "authorized_official_first_name": "BETRAND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-683-8313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, CRNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Lanham, MD
• Providers in Lanham, 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 Jul 12, 2024; 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.