Individual provider Active NPI

Moreen Adeka Mungore

  • Registered Nurse
  • Adelphi, MD
National Provider Identifier
1649929704
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R244299 Issued in MD
Practice address
1814 Metzerott Rd Apt 24
Adelphi, MD 20783-5157
Phone
(240) 705-4442
NPI assigned
Mar 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R244299 MD Primary

Addresses

Primary practice location

1814 Metzerott Rd Apt 24
Adelphi, MD 20783-5157

Mailing address

1814 Metzerott Rd Apt 24
Adelphi, MD 20783-5157
Phone (240) 705-4442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R244299MDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1649929704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 METZEROTT RD APT 24",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207835157",
            "telephone_number": "240-705-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 METZEROTT RD APT 24",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207835157",
            "telephone_number": "240-705-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNGORE",
        "first_name": "MOREEN",
        "middle_name": "ADEKA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R244299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adelphi, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.