Individual provider Active NPI

Eberechukwu Nwaogu, FNP-BC

  • Family Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1831522176
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012014104 Issued in MD
Practice address
14502 Greenview Dr Ste 300a
Laurel, MD 20708-4247
Phone
(301) 300-8624
Fax
(240) 636-6899
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2012014104 MD Primary

Addresses

Primary practice location

14502 Greenview Dr Ste 300a
Laurel, MD 20708-4247

Mailing address

14101 Castle Blvd
Apt 101
Silver Spring, MD 20904-4722
Phone (301) 802-5927

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
I20140821000187 DC Practitioner - Nurse Practitioner 4587882261 Reassigns benefits to 2 organizations
I20140821000287 MD Practitioner - Nurse Practitioner 4587882261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14502 Greenview Dr
Suite 108
Laurel, MD 20708-4233
Phone (301) 802-5927

14502 Greenview Dr
Suite 360
Laurel, MD 20708-4232
Phone (240) 200-4464

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012014104MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icare Health Services Family CurrentSince Apr 1, 2020 Accepting new patients
Active Infusions Inc CurrentSince Mar 8, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

14502 Greenview Dr
Ste 108
Laurel, MD 20708
Phone (301) 300-8624

14502 Greenview Dr
Ste 300A
Laurel, MD 20708
Phone (240) 468-9540

14502 Greenview Dr
Ste 360
Laurel, MD 20708
Phone (240) 200-4464

8230 Leesburg Pike
Ste 700
Vienna, VA 22182
Phone (240) 200-4464

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.

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1831522176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14101 CASTLE BLVD",
            "address_2": "APT 101",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209044722",
            "telephone_number": "301-802-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 GREENVIEW DR STE 300A",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207084247",
            "telephone_number": "301-300-8624",
            "fax_number": "240-636-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWAOGU",
        "first_name": "EBERECHUKWU",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "2012014104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.