Individual provider Active NPI

Anderline Noutai

  • Nurse Practitioner
  • Landover, MD
National Provider Identifier
1891326500
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R149646 Issued in MD
Practice address
8181 Professional PL Ste 200
Landover, MD 20785-7219
Phone
(301) 306-4590
NPI assigned
Jan 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X R149646 MD
Nurse Practitioner 363L00000X R149646 MD Primary

Addresses

Primary practice location

8181 Professional PL Ste 200
Landover, MD 20785-7219

Mailing address

11114 Lake Victoria LN
Bowie, MD 20720-4258
Phone (202) 591-9059

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
I20250123002635 MD Practitioner - Nurse Practitioner 2860746104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R149646MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Perspective Health LLC Single Specialty CurrentSince Dec 7, 2024 Accepting new patients
Interdynamics, Inc. PastSince Jan 8, 2020 Accepting new patients

Organizations & group practices 2

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": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1891326500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11114 LAKE VICTORIA LN",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207204258",
            "telephone_number": "202-591-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8181 PROFESSIONAL PL STE 200",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207857219",
            "telephone_number": "301-306-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOUTAI",
        "first_name": "ANDERLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R149646",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R149646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Landover, MD

Sources for this page

Verify at the official NPI Registry.