Active NPI
Agerie Ejigu, CRNP-PMH
- Psychiatric/Mental Health Nurse Practitioner
- Bethesda, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- R168759
- Practice address
- 6040 Southport Dr
Bethesda, MD 20814-1848 - Phone
- (301) 493-4200
- NPI assigned
- Oct 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R168759 | MD | Primary |
Addresses
Primary practice location
6040 Southport Dr
Bethesda, MD 20814-1848
Mailing address
6040 Southport Dr
Bethesda, MD 20814-1848
Phone (301) 493-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R168759 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Della Behavioral Health Services | Current | Accepting new patients | |
| Cornerstone Montgomery, Inc. | Current | Accepting new patients | |
| Axis Healthcare Group | Current | Accepting new patients | |
| Jewish Community Services, Inc | Current | Accepting new patients | |
| Cornerstone Montgomery, Inc. | Current | Accepting new patients | |
| Green Ridge Behavioral Health, LLC | Past | Accepting new patients |
Locations
5028 Wisconsin Ave NW
Ste 400
Washington, DC 20016
Phone (202) 237-2700
1150 Varnum St NE
Washington, DC 20017
Phone (202) 269-7000
1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000
5750 Park Heights Ave
Baltimore, MD 21215
Phone (410) 466-9200
6040 Southport Dr
Bethesda, MD 20814
Phone 3014934200228
5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171
9841 Broken Land Pkwy
Ste 314
Columbia, MD 21046
Phone (410) 929-7225
7067 Columbia Gateway Dr
Ste 180
Columbia, MD 21046
Phone (410) 925-7225
25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106
2 Taft Ct
Ste 200
Rockville, MD 20850
Phone (301) 715-3673
Organizations & group practices 6
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bethesda, MD
- NPI 1194725739
DC
-
- Clinical Social Worker
- Baltimore, MD
- NPI 1023000320
-
- Adult Mental Health Clinic/Center
- Silver Spring, MD
- NPI 1174995781
-
- Neurology Physician
- Silver Spring, MD
- NPI 1285041616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476662400000",
"number": "1871044784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6040 SOUTHPORT DR",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208141848",
"telephone_number": "301-493-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6040 SOUTHPORT DR",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208141848",
"telephone_number": "301-493-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EJIGU",
"first_name": "AGERIE",
"credential": "CRNP-PMH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-17",
"last_updated": "2016-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MD",
"license": "R168759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.