Individual provider Active NPI

Colman Ejerenwa, NP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1821635749
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R197772 Issued in MD
Practice address
1922 W Pratt Street
Baltimore, MD 21223
Phone
(301) 536-0044
NPI assigned
Dec 10, 2019
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R197772 MD Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R197772 MD

Addresses

Primary practice location

1922 W Pratt Street
Baltimore, MD 21223

Mailing address

1922 W Pratt Street
Baltimore, MD 21223
Phone (301) 536-0044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200324002570 DC Practitioner - Nurse Practitioner 1254769342 Reassigns benefits to 1 organization
I20200324003214 MD Practitioner - Nurse Practitioner 1254769342 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
M Medical Group, Inc.Group PAC ID 7719278597, 104 clinicians

Practice addresses (Care Compare)

1807 Pennsylvania Ave
Baltimore, MD 21217-3214

22 S Athol Ave
Futurecare Irvington
Baltimore, MD 21229-3405
Phone (410) 947-3052

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
77.19
Improvement activities
40
Cost
63.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R197772MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
M Medical Group, Inc. Current Accepting new patients
M Medical Group, Inc. CurrentSince Aug 23, 2022 Accepting new patients
M Medical Group, Inc. CurrentSince Aug 23, 2022 Accepting new patients
Quick Care Clinic Inc CurrentSince Dec 14, 2022 Accepting new patients
Toller Enterprises LLC Family CurrentSince Jun 1, 2021 Accepting new patients
Toller Enterprises LLC Psychiatric/Mental Health CurrentSince Jun 1, 2021 Accepting new patients
Quick Care Clinic Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Quick Care Clinic Inc Past Accepting new patients
Quick Care Clinic Inc Past Accepting new patients

Locations

22 S Athol Ave
Baltimore, MD 21229
Phone (410) 566-5015

2232 E Monument St
Baltimore, MD 21205
Phone (667) 207-3552

9106 Pine View Ln
Clinton, MD 20735
Phone (301) 856-2930

1 Price Dr
Elkton, MD 21921
Phone (410) 398-6474

30 North Pl
Frederick, MD 21701
Phone (301) 695-6618

8136 Liberty Rd
Ste C
Windsor Mill, MD 21244
Phone (240) 784-0241

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1821635749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 W PRATT STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21223",
            "telephone_number": "301-536-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 W PRATT STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21223",
            "telephone_number": "301-536-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJERENWA",
        "first_name": "COLMAN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-10",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R197772",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R197772",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.