Diversity Health Clinic, LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

DIVERSITY HEALTH CLINIC, LLC

Doing business as

Diversity Health Clinic, LLC

Practice address

15101 Centergate Dr
Silver Spring, MD 20905-5714

Phone

(301) 793-4761

Fax

(800) 519-7417

NPI assigned

Nov 13, 2020

Last updated

Nov 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Akukeng W. Mba, CRNPNPI 1043686876

Title

Nurse Practitioner

Phone

(301) 793-4761

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Diversity Health Clinic, LLC Doing business as

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23411/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Akukeng Mba, FAMILY AND PSYCHIATR

  • Nurse Practitioner
  • Germantown, MD
  • NPI 1043686876
  NPD Authorized official
• Abraham Apene Mbangowah, NP

  • Family Nurse Practitioner
  • Silver Spring, MD
  • NPI 1710523022

  Primary Care

  NPD

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1780286732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15101 CENTERGATE DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209055714",
            "telephone_number": "301-793-4761",
            "fax_number": "800-519-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15101 CENTERGATE DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209055714",
            "telephone_number": "301-793-4761",
            "fax_number": "800-519-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSITY HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "MBA",
        "authorized_official_first_name": "AKUKENG",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "301-793-4761",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R185268",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diversity Health Clinic, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrick Disalvo, LCSW
• Leon R. Discavage
• Discovery Pediatrics, LLC
• District Wellness Consulting
• Diversity Health Care, LLC
• Agnes Therese Enopia Divinagracia, P.T.
• Divine Chiropractic and Rehabilitation LLC
• Divine Wellness and Psychiatric Services
• Atoinette Leslie Diwongui Ekane Epse Fankam
• Devon Harold Dixon

• Primary Care Nurse Practitioner in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Primary Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.