Mariah Owusu-Agyei, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2026-01913 Issued in NC

Practice address

3526 Village Dr
Fayetteville, NC 28304-4554

Phone

(910) 609-3970

Fax

(910) 615-9671

NPI assigned

Jun 11, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Richard Lee Averitte Jr PLLC

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1407804115

  Multi-Specialty

  Medicare reassignment NPD
• Richard Lee Averitte Jr PLLC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1609291848

  Multi-Specialty

  NPD (past)
• Richard Lee Averitte Jr., PLLC

  • Non-Pharmacy Dispensing Site
  • Surprise, AZ
  • NPI 1598112831
  NPD (past)
• Richard Lee Averitte Jr., PLLC

  • Non-Pharmacy Dispensing Site
  • Anthem, AZ
  • NPI 1619428851
  NPD (past)

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1770108193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N CAROLINE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3526 VILLAGE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044554",
            "telephone_number": "910-609-3970",
            "fax_number": "910-615-9671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-4000",
            "fax_number": "910-672-0350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWUSU-AGYEI",
        "first_name": "MARIAH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2026-01913",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "71856",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "71856",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron Douglas Owens, M.A.
• David V Owens, RPH
• Kenyeta Owens
• Seth Owens
• Mary Boateng Oworae
• Andella Oxendine
• Felicity D Oxendine
• Frankie Alan Oxendine, LMFT
• Gena Oxendine, LPCA
• Lauren Michelle Oxendine, DMD

• Dermatology Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.