Individual provider Active NPI

Charles Wangui, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1861034159
Registry record updated Apr 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R198299 Issued in MD
Practice address
2245 Eastern Ave
Baltimore, MD 21231-3113
Phone
(443) 489-9009
NPI assigned
Oct 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R198299 MD Primary

Addresses

Primary practice location

2245 Eastern Ave
Baltimore, MD 21231-3113

Mailing address

2245 Eastern Ave
Baltimore, MD 21231-3113
Phone (443) 489-9009

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
I20200113002161 MD Practitioner - Nurse Practitioner 1951736362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Overcare Health Services LLCGroup PAC ID 6507254398, 5 clinicians

Practice addresses (Care Compare)

16 Flaxleaf CT
Baltimore, MD 21221-1752
Phone (443) 739-4202

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Overcare Health Services LLC Psychiatric/Mental Health CurrentSince Sep 15, 2021 Accepting new patients
Johns Hopkins University Psychiatry CurrentSince Feb 10, 2020 Accepting new patients
Overcare Health Services LLC CurrentSince Aug 18, 2021 Accepting new patients
Johns Hopkins University CurrentSince Feb 10, 2020 Accepting new patients
Johns Hopkins University Current Accepting new patients
Overcare Health Services LLC Past Accepting new patients
Overcare Health Services LLC Past Accepting new patients

Locations

2245 Eastern Ave
Baltimore, MD 21231
Phone (410) 675-6046

520 Forrest St
Baltimore, MD 21202
Phone (443) 489-9009

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

10755 Falls Rd
Timonium, MD 21093
Phone (410) 583-2727

Interoperability endpoints

  • Direct secure messaging: cwangui380710@direct.hopkinsmedicine.org

Organizations & group practices 7

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": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1861034159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212313113",
            "telephone_number": "443-489-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212313113",
            "telephone_number": "443-489-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGUI",
        "first_name": "CHARLES",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-08",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R198299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.