NPIMap

Organization Active NPI

Practistat

  • Family Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1972230639
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PRACTISTAT
Practice address
5457 Twin Knolls Rd Ste 300
Columbia, MD 21045-3296
Phone
(240) 461-9005
NPI assigned
Aug 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Authorized official

Name
Dr. Muniratu Fabode, APRN
Title
Owner
Phone
(240) 461-9005

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

5457 Twin Knolls Rd Ste 300
Columbia, MD 21045-3296

Mailing address

5457 Twin Knolls Rd Ste 300
Columbia, MD 21045-3296
Phone (240) 461-9005

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1972230639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5457 TWIN KNOLLS RD STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453296",
            "telephone_number": "240-461-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5457 TWIN KNOLLS RD STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453296",
            "telephone_number": "240-461-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRACTISTAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "FABODE",
        "authorized_official_first_name": "MUNIRATU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-461-9005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.