Immirne Monet Ouwinga, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0078131 Issued in MD

Practice address

10845 Town Center Blvd
Suite 102
Dunkirk, MD 20754-2712

Phone

(410) 535-5660

Fax

(410) 535-5722

NPI assigned

Aug 5, 2008

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Clinic, IncGroup PAC ID 6204722614, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: immirne.ouwinga@ccicares.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Clinic, Inc.

  dba CCI Health Services

  • Federally Qualified Health Center (FQHC)
  • Takoma Park, MD
  • NPI 1790730281

  DC

  Medicare reassignment Care Compare group NPD
• Community Clinic, Inc

  dba CCI Ora Glen Pharmacy

  • Community/Retail Pharmacy
  • Greenbelt, MD
  • NPI 1295560878
  NPD
• Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gaithersburg, MD
  • NPI 1699817775
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1588820971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784017",
            "telephone_number": "410-414-4791",
            "fax_number": "410-414-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10845 TOWN CENTER BLVD",
            "address_2": "SUITE 102",
            "city": "DUNKIRK",
            "state": "MD",
            "postal_code": "207542712",
            "telephone_number": "410-535-5660",
            "fax_number": "410-535-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUWINGA",
        "first_name": "IMMIRNE",
        "middle_name": "MONET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036128568",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125055374",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0078131",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MD",
            "license": "D78131",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Penuel Behavioral Health Services LLC
• Penuel Behavioral Health Services LLC.
• Penuel Behavioral Health Services LLC.

• Family Medicine Physician in Dunkirk, MD
• Providers in Dunkirk, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.