Individual provider Active NPI

Herman Ndungu, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Abingdon, MD
National Provider Identifier
1992345714
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R190177 Issued in MD
Practice address
3105 Emmorton Rd Ste 2D
Abingdon, MD 21009-2591
Phone
(443) 693-7301
NPI assigned
Jan 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R190177 MD Primary

Addresses

Primary practice location

3105 Emmorton Rd Ste 2D
Abingdon, MD 21009-2591

Mailing address

3105 Emmorton Rd Ste 2D
Abingdon, MD 21009-2591
Phone (443) 693-7301

Other practice location 1

4500 47th Ave Ste 5A
Sacramento, CA 95824-3847
Phone (916) 230-9768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20200724000801 MD Practitioner - Nurse Practitioner 1355765272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3105 Emmorton Rd
Suite 2D
Abingdon, MD 21009-2591
Phone (443) 693-7301

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiant Wellness & Recovery, a Professional Nursing Corporation Psychiatric/Mental Health CurrentSince Nov 9, 2025 Accepting new patients
Gateway Healthcare Connections Current Accepting new patients

Locations

4500 47th Ave
Ste 5A
Sacramento, CA 95824
Phone (916) 230-9768

Organizations & group practices 3

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": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1992345714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 EMMORTON RD STE 2D",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210092591",
            "telephone_number": "443-693-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 EMMORTON RD STE 2D",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210092591",
            "telephone_number": "443-693-7301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 47th Ave Ste 5A",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958243847",
            "country_code": "US",
            "telephone_number": "916-230-9768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NDUNGU",
        "first_name": "HERMAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-09",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R190177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, MD

Sources for this page

Verify at the official NPI Registry.