Individual provider Active NPI

Mercy Oluchi Eke, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Randallstown, MD
National Provider Identifier
1801564745
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R177068 Issued in MD
Practice address
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone
(410) 521-2200
NPI assigned
Sep 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X R177068 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R177068 MD Primary

Addresses

Primary practice location

5401 Old Court Rd
Randallstown, MD 21133-5103

Mailing address

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220514000288 MD Practitioner - Nurse Practitioner 4981081866 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebridge Community Physicians IncGroup PAC ID 3678751468, 183 clinicians

Practice addresses (Care Compare)

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-2200

Hospital & facility affiliations

  • Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
60.26
Promoting interoperability
100
Improvement activities
40
Cost
76.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R177068MDMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc. CurrentSince Apr 30, 2022 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Apr 30, 2022 Accepting new patients
Bridging Gaps Through Positive Solutions CurrentSince Jun 12, 2024 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Bridging Gaps Through Positive Solutions CurrentSince Jun 12, 2024 Accepting new patients

Locations

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

8508 Loch Raven Blvd
Towson, MD 21286
Phone (410) 296-7222

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1630713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1801564745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-521-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-521-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKE",
        "first_name": "MERCY",
        "middle_name": "OLUCHI",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-04",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R177068",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R177068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

Verify at the official NPI Registry.