Individual provider Active NPI

Bobbie Nnodim

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1649821166
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R193493 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(443) 570-4815
NPI assigned
Sep 25, 2019
Last updated
Mar 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R193493 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

993 Rohe Farm LN
Baltimore, MD 21220-1548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191122000511 MD Practitioner - Nurse Practitioner 5395177794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Empowering Minds Resource CenterGroup PAC ID 2062821929, 3 clinicians
Norkris Services IncGroup PAC ID 3375848625, 6 clinicians

Practice addresses (Care Compare)

1800 N Charles St
Suite 600
Baltimore, MD 21201-5990
Phone (443) 379-3852

611 S Union Ave
Havre de Grace, MD 21078-3421
Phone (443) 526-6133

7954 Baltimore Annapolis Blvd
Suite 2E
Glen Burnie, MD 21060-8187
Phone (410) 363-3713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R193493MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Empowering Minds Resource Center CurrentSince Jan 16, 2021 Accepting new patients
Empowering Minds Resource Center CurrentSince Jan 16, 2021 Accepting new patients
Lawren Healthcare Services Current Accepting new patients
Norkris Services, Inc Psychiatric/Mental Health CurrentSince Nov 26, 2019 Accepting new patients

Locations

1800 N Charles St
Ste 600
Baltimore, MD 21201
Phone (410) 625-5088

611 S Union Ave
Hvre de Grace, MD 21078
Phone (443) 526-6133

10451 Mill Run Cir
Ste 400
Owings Mills, MD 21117
Phone (443) 219-8482

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1649821166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "993 ROHE FARM LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212201548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "443-570-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNODIM",
        "first_name": "BOBBIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R193493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.