NPIMap

Organization Active NPI

Medivine Healthcare Services Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1922739432
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MEDIVINE HEALTHCARE SERVICES INC
Practice address
8506 Snowden Loop
Laurel, MD 20708-2360
Phone
(240) 501-0232
NPI assigned
Jun 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Authorized official

Name
Ogochukwu Enyi, PMHNPNPI 1194068866
Title
Ceo
Phone
(240) 501-0232

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

8506 Snowden Loop
Laurel, MD 20708-2360

Mailing address

8506 Snowden Loop
Laurel, MD 20708-2360
Phone (240) 501-0232

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1922739432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8506 SNOWDEN LOOP",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082360",
            "telephone_number": "240-501-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8506 SNOWDEN LOOP",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082360",
            "telephone_number": "240-501-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIVINE HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "ENYI",
        "authorized_official_first_name": "OGOCHUKWU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-501-0232",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.