Idaat Bisola Timbo-Jalloh

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R209309 Issued in MD

Practice address

7310 Ritchie Hwy Ste 200
Glen Burnie, MD 21061-3065

Phone

(410) 446-7479

NPI assigned

Sep 9, 2022

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD, DC2 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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Della Behavioral Health ServicesGroup PAC ID 3971755000, 54 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: arkofrehabilitation.idaattimbo-jalloh@159992.advancedmd-direct.com

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.

• Della Behavioral Health Services

  dba CounterPoint Health Services

  • Psychologist
  • Columbia, MD
  • NPI 1750635207

  DC

  Medicare reassignment Care Compare group NPD
• Bisfol Mental Care Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glen Burnie, MD
  • NPI 1871315200
  NPD Authorized official

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1841911500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8285 W B AND A RD",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211442704",
            "telephone_number": "410-446-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 RITCHIE HWY STE 200",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613065",
            "telephone_number": "410-446-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMBO-JALLOH",
        "first_name": "IDAAT",
        "middle_name": "BISOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R209309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841911500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "T-512-329-089-775",
            "identifier": "T-512-329-089-775",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Robert Ticehurst, M.D.
• Donna Lorraine Ticknor, M.D.
• Tidewater LLC
• Shannon Liedquist Tieman, CRNP
• Kaitlin Tierney, PT, DPT
• Time Organization
• Time Organization, Inc
• Eileen Bradley Timm, R.N.
• Lauren A Timpson, P.A.-C.
• Ronda B. Tinsley, CAC - AD

• Psychiatric/Mental Health Nurse Practitioner in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.