Eta Stephen Tataw, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R178223 Issued in MD

Practice address

7231 Hanover Pkwy Ste a
Greenbelt, MD 20770-2027

Phone

(301) 982-7898

Fax

(301) 982-2588

NPI assigned

Sep 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: etatataw@etfamilypractice.officeally.direct

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.

• Et Healthcare Foundation,Inc.

  • Family Nurse Practitioner
  • Greenbelt, MD
  • NPI 1982236774
  NPD Authorized official
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1821347592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7231 HANOVER PKWY STE A",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702027",
            "telephone_number": "301-982-7898",
            "fax_number": "301-982-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7231 HANOVER PKWY STE A",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702027",
            "telephone_number": "301-982-7898",
            "fax_number": "301-982-2588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8600 Snowden River Pkwy Ste 306",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210451986",
            "country_code": "US",
            "telephone_number": "443-546-4172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATAW",
        "first_name": "ETA",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-10",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R178223",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1011938",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337807100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424652700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivian Ebi Tanyi Fultang
• Orang Ayuk Tanyi
• Nosta Tanyidah
• Mary Tarawaley
• Mirene Tatah
• Stephen A Tatu, HHA
• Susan Ashley Taylor, CMA, MSW, LCSW-C
• Amin Tazitabong
• Caline Tchakounte
• Lilian Tchinda Muafor

• Family Nurse Practitioner in Greenbelt, MD
• Providers in Greenbelt, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.