MANDY COLEGROVE (NPI# 1437569407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437569407 |
| Entity Type | Individual |
| Full Name | MANDY COLEGROVE |
| Credential | CRNP |
| Practice Address |
103 Centennial St Suite B La Plata MD 20646-5984 |
| Mailing Address |
103 Centennial St Suite C La Plata MD 20646-5984 |
| Practice Telephone | 3019349111 |
| Practice Fax Number | 3019349333 |
| Mailing Telephone | 3019349111 |
| Mailing Fax Number | 3019349333 |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
R154963 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
103 CENTENNIAL ST SUITE B |
| City | LA PLATA |
| State | MD |
| Zip Code | 20646-5984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033304381 | Joshua Tennant | Physical Medicine & Rehabilitation | 103 Centennial St, Suite H, La Plata, MD 20646-5984 | 2007-09-10 |
| 1891001996 | La Plata Pediatrics & Family Health, LLC | Clinic/Center | 103 Centennial St, Suite B, La Plata, MD 20646-5984 | 2010-08-26 |
| 1508185505 | Jamie Lee Reidy | Nurse Practitioner | 103 Centennial St, Suite B, La Plata, MD 20646-5984 | 2010-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718822 | Charles Regional Surgical Center LLC | Clinic/Center | 5 North Laplata Court, 2nd Floor, Laplata, MD 20646 | 2020-07-27 |
| 1902387988 | Sheldon Villarta | Physical Therapist | 10200 La Plata Town, La Plata, MD 20646 | 2018-08-27 |
| 1912485244 | Kelli Hill Goldsborough | Nurse Practitioner | 5 N La Plata Ct Ste 101, La Plata, MD 20646 | 2018-07-30 |
| 1083128490 | Charles County Rescue Squad Inc | Ambulance | 2 Calvert St, La Plata, MD 20646 | 2017-11-21 |
| 1801261532 | Catherine Deshetler | Social Worker | 5 N Maple Ave Ste 206, La Plata, MD 20646 | 2015-12-07 |
| 1215346481 | Brittany Godin | Speech-Language Pathologist | 5 Garrett Avenue, La Plata, MD 20646 | 2014-08-12 |
| 1558787606 | Homeplace Assisted Living | Assisted Living Facility | 10210 La Plata Rd, La Plata, MD 20646 | 2014-03-13 |
| 1891056628 | Godfrey T Hewitt | Dentist | 6620 Crain Hwy #204, Laplata, MD 20646 | 2012-06-07 |
| 1740573823 | Armida Bondoc Gonzales | Physical Therapist | 15 S Maple Ave, Apt 2, La Plata, MD 20646 | 2011-05-23 |
| 1023315348 | Charity E Dugan | Surgery | Um Charles Regional Medical Group, 5 North La Plata Court Ste 103, La Plata, MP 20646 | 2011-02-23 |
| Find all providers in zip 20646 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912485244 | Kelli Hill Goldsborough | Nurse Practitioner | 5 N La Plata Ct Ste 101, La Plata, MD 20646 | 2018-07-30 |
| 1952860660 | Modupe Fadojutimi | Nurse Practitioner | 1 Magnolia Dr, La Plata, MD 20646-9357 | 2019-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134934 | Healthy Option Clinic, LLC | Nurse Practitioner | 101 Egypt Farms Rd, Owings Mills, MD 21117-5043 | 2020-11-07 |
| 1598364192 | Folasade O Onasanya | Nurse Practitioner | 3312 Croydon Rd, Baltimore, MD 21207-4543 | 2020-10-23 |
| 1407460421 | Nkechi Okeh | Nurse Practitioner | 9603 Glenkirk Way, Bowie, MD 20721-2998 | 2020-09-08 |
| 1780298588 | Andreli Professional Advising and Resources, LLC | Nurse Practitioner | 9730 Morningview Cir, Perry Hall, MD 21128-9024 | 2020-08-31 |
| 1194336941 | Phoebe Vuwansi Chongong | Nurse Practitioner | 10300 Crystal Brook Ct, Upper Marlboro, MD 20772-6687 | 2020-08-14 |
| 1306457122 | Trusted and Innovative Inc | Nurse Practitioner | 4600 Powder Mill Rd Ste 450, Beltsville, MD 20705-2686 | 2020-08-14 |
| 1225653611 | Zynith Health Care & Associates | Nurse Practitioner | 4061 Powder Mill Rd Ste 101, Beltsville, MD 20705-3156 | 2020-06-11 |
| 1124640974 | Liberty Family Care | Nurse Practitioner | 8515 Liberty Rd Ste B, Randallstown, MD 21133-4832 | 2020-05-15 |
| 1437785706 | Hajia M Nagaiya | Nurse Practitioner | 3525 Courtleigh Dr, Baltimore, MD 21244-2205 | 2020-03-19 |
| 1578195475 | Baltimore Healthcare At Home, LLC | Nurse Practitioner | 9501 Branchleigh Rd, Randallstown, MD 21133-2056 | 2020-02-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.