Individual provider Active NPI

Mohamed Chernor Jalloh

  • Family Nurse Practitioner
  • Bowie, MD
National Provider Identifier
1689527780
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R193648 Issued in MD
Practice address
17201 Russet Dr
Bowie, MD 20716-3602
Phone
(301) 741-0222
NPI assigned
Feb 18, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X R193648 MD Primary

Addresses

Primary practice location

17201 Russet Dr
Bowie, MD 20716-3602

Mailing address

17201 Russet Dr
Bowie, MD 20716-3602
Phone (301) 741-0222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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

Enrollment IDStateProvider typePAC IDDetails
I20260519004781 DC Practitioner - Nurse Practitioner 8426527334 Reassigns benefits to 1 organization
I20260611001364 MD Practitioner - Nurse Practitioner 8426527334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1205 York Rd
Suite 11
Timonium, MD 21093-6226

9722 Groffs Mill Dr
Owings Mills, MD 21117-6341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R193648MDMDFamily Nurse Practitioner

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1771372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1689527780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17201 RUSSET DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163602",
            "telephone_number": "301-741-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17201 RUSSET DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163602",
            "telephone_number": "301-741-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALLOH",
        "first_name": "MOHAMED",
        "middle_name": "CHERNOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-18",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R193648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.