Individual provider Active NPI

Paul CHI Ateghang

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowie, MD
National Provider Identifier
1962276121
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R245319 Issued in MD
Practice address
14108 Guardian CT
Bowie, MD 20715-1748
Phone
(301) 254-5357
NPI assigned
Nov 8, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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 R245319 MD Primary
Registered Nurse 163W00000X R245319 MD

Addresses

Primary practice location

14108 Guardian CT
Bowie, MD 20715-1748

Mailing address

14108 Guardian CT
Bowie, MD 20715-1748
Phone (301) 254-5357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20251211000919 DC Practitioner - Nurse Practitioner 6406361872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14108 Guardian CT
Bowie, MD 20715-1748

3601 Hamilton St
Suite 205
Hyattsville, MD 20782-3946

8201 Corporate Dr
Suite 630
Hyattsville, MD 20785-2258

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R245319MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harmonious Healthcare Services LLC Single Specialty CurrentSince Feb 21, 2025 Accepting new patients

Locations

3601 Hamilton St
Ste 205
Hyattsville, MD 20782
Phone (301) 254-5357

Interoperability endpoints

  • Direct secure messaging: pateghang685957@direct.umm.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1962276121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14108 GUARDIAN CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151748",
            "telephone_number": "301-254-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14108 GUARDIAN CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151748",
            "telephone_number": "301-254-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATEGHANG",
        "first_name": "PAUL",
        "middle_name": "CHI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R245319",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R245319",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.