Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PROVIDENCE HEALTH GROUP LLC
NPI 1205773264
Nurse Practitioner - Psychiatric/Mental Health in Bowie, MD

Q: What is Providence Health Group LLC's NPI number?

The NPI number for Providence Health Group LLC is 1205773264. It was assigned to this organization in the NPPES registry on April 29, 2026.

Q: What is Providence Health Group LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since April 29, 2026

3060 MITCHELLVILLE RD # 6-A, BOWIE, MD 20716(908) 906-7518 Get Directions Write a Review

NPPES record last updated: August 6, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 6, 2026, Apr 29, 2026 (2 updates tracked since 2026).

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About Providence Health Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE HEALTH GROUP LLC (NPI 1205773264) is a healthcare organization registered as a psychiatric/mental health in Bowie, Maryland and active in the NPI registry since April 2026. The organization lists Ijeoma Mgboji, Owner, as its authorized official.

NPPES Registry Identity

NPI1205773264

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NamePROVIDENCE HEALTH GROUP LLC

Location Address3060 MITCHELLVILLE RD # 6-ABowie, MD 20716-1389

Mailing Address3060 Mitchellville Rd # 6-aBowie, MD 20716-1389

Phone(908) 906-7518

Organization SubpartNo

Authorized OfficialIjeoma MgbojiOwner · (908) 906-7518

Enumeration DateApril 29, 2026

Last NPPES UpdateAugust 6, 20262 updates tracked since enumeration

NPPES CertifiedAugust 6, 2026

✔ NPI 1205773264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

3060 MITCHELLVILLE RD # 6-A, Bowie, MD 20716

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Health Group LLC's NPI number?

The NPI number for Providence Health Group LLC is 1205773264. It was assigned to this organization in the NPPES registry on April 29, 2026.

Where is Providence Health Group LLC located?

Providence Health Group LLC is located at 3060 Mitchellville Rd # 6-A, Bowie, MD 20716. The listed phone number is (908) 906-7518.

What is Providence Health Group LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Providence Health Group LLC was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.