NPIMap

Organization Active NPI

Dawamed LLC

  • Gerontology Nurse Practitioner
  • Parkville, MD
National Provider Identifier
1770196511
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Legal business name
DAWAMED LLC
Practice address
8117 Harford Rd # 2
Parkville, MD 21234-5792
Phone
(410) 900-4619
Fax
(531) 200-7379
NPI assigned
Aug 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Authorized official

Name
Leonard MugoNPI 1659815520
Title
Director
Phone
(410) 900-4619

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

8117 Harford Rd # 2
Parkville, MD 21234-5792

Mailing address

4611 Southwood Ave
Baltimore, MD 21206-2245

Other practice location 1

4611 Southwood Ave
Baltimore, MD 21206-2245
Phone (400) 900-4619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201020001962 MD Part B Supplier - Clinic/Group Practice 1658791215 Receives reassigned benefits from 2 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Tax ID family
Dawamed LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8117 Harford Rd
#2
Parkville, MD 21234
Phone (410) 900-4619

Practitioners & affiliated clinicians

Practitioners 2

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": "1598745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1770196511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 SOUTHWOOD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212062245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8117 HARFORD RD # 2",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212345792",
            "telephone_number": "410-900-4619",
            "fax_number": "531-200-7379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4611 Southwood Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212062245",
            "country_code": "US",
            "telephone_number": "400-900-4619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAWAMED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-30",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "MUGO",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-900-4619"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.