Sophia Ugonma Atu

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R191076 Issued in MD

Practice address

610 Professional Dr Ste 255
Gaithersburg, MD 20879-3463

Phone

(240) 683-6202

NPI assigned

May 19, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Green Ridge Behavioral Health, LLCGroup PAC ID 3476685181, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Green Ridge Behavioral Health, LLC

  • Neurology Physician
  • Rockville, MD
  • NPI 1407088339

  DC

  Medicare reassignment Care Compare group NPD
• Unique Behavioral Health Inc.

  • Psychiatry Physician
  • Lanham, MD
  • NPI 1205609435

  DC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1669119640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9203 ROLLING VIEW DR",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062457",
            "telephone_number": "240-535-0454",
            "fax_number": "240-683-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 PROFESSIONAL DR STE 255",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793463",
            "telephone_number": "240-683-6202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9203 Rolling View Dr",
            "address_purpose": "LOCATION",
            "city": "Lanham",
            "state": "MD",
            "postal_code": "207062457",
            "country_code": "US",
            "telephone_number": "240-535-0454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATU",
        "first_name": "SOPHIA",
        "middle_name": "UGONMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R191076",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R191076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "largo",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Cheverly",
            "address_1": "9203 Rolling View Dr",
            "city": "Lanham",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207062457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Atlantic Audiology, LLC
• Atlas Professional Home Care
• Ismail Atolagbe
• Michele Karel Atse
• Attan Kasid MD PC
• Carley Rachel Aubertin
• Gregory Charles Aubertin, DPM
• Authentic Mental Wellness LLC
• Autumn Health Inc
• Avalon Health LLC

• Psychiatric/Mental Health Nurse Practitioner in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; 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.