Individual provider Active NPI

Florence Ifeoma Omerennah, RD LD/N

  • Registered Dietitian
  • Largo, MD
National Provider Identifier
1952547911
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DX2507 Issued in MD
Practice address
1300 Mercantile LN Ste 129-37
Largo, MD 20774-5327
Phone
(301) 341-4680
NPI assigned
Dec 22, 2008
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DX2507 MD Primary

Addresses

Primary practice location

1300 Mercantile LN Ste 129-37
Largo, MD 20774-5327

Mailing address

210 Settlers Way
Upper Marlboro, MD 20774-5770
Phone (301) 341-4680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110321000530 DC Practitioner - Registered Dietitian Or Nutrition Professional 9739362302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 Settlers Way
Upper Marlboro, MD 20774-5770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Nutrition Services LLC CurrentSince Sep 6, 2018 Accepting new patients

Locations

1300 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 583-0001

1300 Mercantile Ln
Ste 12937
Upper Marlboro, MD 20774
Phone (301) 341-4680

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1952547911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SETTLERS WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745770",
            "telephone_number": "301-341-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN STE 129-37",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745327",
            "telephone_number": "301-341-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMERENNAH",
        "first_name": "FLORENCE",
        "middle_name": "IFEOMA",
        "credential": "RD LD/N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX2507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.