Individual provider Active NPI

Olive Mouafo

  • Family Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1962027599
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R180144 Issued in MD
Practice address
10100 Snowdrift Downs
Laurel, MD 20723-5873
Phone
(240) 723-6907
NPI assigned
Jun 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R180144 MD Primary

Addresses

Primary practice location

10100 Snowdrift Downs
Laurel, MD 20723-5873

Mailing address

10100 Snowdrift Downs
Laurel, MD 20723-5873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201014001537 MD Practitioner - Nurse Practitioner 4880014752 Reassigns benefits to 2 organizations
I20210929000522 DC Practitioner - Nurse Practitioner 4880014752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRH MD Management LLCGroup PAC ID 2466841028, 70 clinicians

Practice addresses (Care Compare)

11804 Reisterstown Rd
Reisterstown, MD 21136-3311
Phone (410) 870-5094

14421 Baltimore Ave
Laurel, MD 20707-4949
Phone (240) 786-6684

Merit-based Incentive Payment System (MIPS)

Final score
53.05 of 100Reported as group
Quality
49.52
Promoting interoperability
0
Improvement activities
40
Cost
77.32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CRH MD Management LLC CurrentSince Feb 1, 2022 Accepting new patients
CRH MD Management, LLC CurrentSince Feb 1, 2022 Accepting new patients
CRH MD Management LLC CurrentSince Feb 1, 2022 Accepting new patients
U N I Medical Care Inc CurrentSince Jul 8, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

590 Lanier Ave W
Fayetteville, GA 30214

6030 Daybreak Cir
Ste A150179
Clarksville, MD 21029

1305 W 7th St
Ste 28
Frederick, MD 21702
Phone (301) 228-3600

11236 Robinwood Dr
Ste 101
Hagerstown, MD 21742
Phone (240) 313-4242

14421 Baltimore Ave
#12202
Laurel, MD 20707
Phone (240) 786-6684

14421 Baltimore Ave
Laurel, MD 20707
Phone (240) 786-6684

11804 Reisterstown Rd
Reisterstown, MD 21136
Phone (410) 870-5094

750 Rockville Pike
Rockville, MD 20852
Phone (301) 424-0658

14090 Hg Trueman Rd
Ste 1300
Solomons, MD 20688
Phone (410) 394-2800

Organizations & group practices 5

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": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1962027599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 SNOWDRIFT DOWNS",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207235873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 SNOWDRIFT DOWNS",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207235873",
            "telephone_number": "240-723-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUAFO",
        "first_name": "OLIVE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R180144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.