NPIMap

Organization Active NPI

Rehoboth Healthcare and Behavioral Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Westminster, MD
National Provider Identifier
1760165088
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
REHOBOTH HEALTHCARE AND BEHAVIORAL SERVICES
Practice address
419 Malcolm Dr Ste a
Westminster, MD 21157-6130
Phone
(443) 821-0717
Fax
(443) 821-0720
NPI assigned
Aug 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Njideka Emenyi, DNP, PMHNP-BC, FNP-CNPI 1912567504
Title
Medical Director
Phone
(443) 821-0717

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

419 Malcolm Dr Ste a
Westminster, MD 21157-6130

Mailing address

735 Blue Moon LN
Westminster, MD 21157-7059
Phone (443) 821-0717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231109000157 MD Part B Supplier - Clinic/Group Practice 1850748013 Receives reassigned benefits from 3 practitioners
Practice locations: Westminster, MD
O20250812000719 DC Part B Supplier - Clinic/Group Practice 1850748013 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Locations

419 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (443) 821-0717

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1760165088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 BLUE MOON LN",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211577059",
            "telephone_number": "443-821-0717",
            "fax_number": "443-821-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 MALCOLM DR STE A",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576130",
            "telephone_number": "443-821-0717",
            "fax_number": "443-821-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHOBOTH HEALTHCARE AND BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-11",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "EMENYI",
        "authorized_official_first_name": "NJIDEKA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "443-821-0717",
        "authorized_official_credential": "DNP, PMHNP-BC, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.