Devine Family Care Practice LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

DEVINE FAMILY CARE PRACTICE LLC

Practice address

8890 McDonogh Rd Ste 211
Owings Mills, MD 21117-5397

Phone

(410) 963-9577

NPI assigned

Dec 16, 2024

Organization subpart

Yes

Parent organization

DEVINE FAMILY CARE PRACTICE LLCAs reported in NPPES

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

Authorized official

Name

Stella Ebere Mbah, DNP, CRNP, FNP-BCNPI 1851787725

Title

Chief Medical Officer

Phone

(443) 200-5338

Specialties & licenses 1

Addresses

Other names 1

• Devine Family Care Practice Doing business as

Tax ID family

Devine Family Care Practice2 organizations share this tax ID, including this one

Part of

Devine Family Care Practice

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Devine Family Care Practice LLC

  • Family Medicine Physician
  • Gwynn Oak, MD
  • NPI 1053828244
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Devine Family Care Practice LLC

  • Family Medicine Physician
  • Gwynn Oak, MD
  • NPI 1053828244
  NPPES parent name

Practitioners 1

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

• Stella Ebere Mbah, CRNP

  • Family Nurse Practitioner
  • Gwynn Oak, MD
  • NPI 1851787725
  NPD Authorized official

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1962219642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8890 MCDONOGH RD STE 211",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175397",
            "telephone_number": "410-963-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8890 MCDONOGH RD STE 211",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175397",
            "telephone_number": "410-963-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVINE FAMILY CARE PRACTICE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEVINE FAMILY CARE PRACTICE LLC",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "MBAH",
        "authorized_official_first_name": "STELLA",
        "authorized_official_middle_name": "EBERE",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "443-200-5338",
        "authorized_official_credential": "DNP, CRNP, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devine Family Care Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pankaj Rohit Desai, M.D., FACP
• Desire Wellness LLC
• Destined 4 Purpose Life Coach
• Destiny House of Restoration Inc.
• Determined Driven and Dedicated for Life
• Devine Nursing Services Unlimited, Inc.
• Diamond Dental of Owings Mills, LLC
• Diamond Healthcare Services LLC
• Diamond Healthcare Services LLC
• Diamond Medical Laboratories, LLC.

• Family Nurse Practitioner in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.