DWAYNE OMAR ENNIS PMHNP-BC
NPI 1700607835
Nurse Practitioner - Psychiatric/Mental Health in La Plata, MD
About Dwayne Omar Ennis Pmhnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DWAYNE OMAR ENNIS PMHNP-BC (NPI 1700607835) is an individual psychiatric/mental health provider in La Plata, Maryland, licensed in Maryland (R173805) and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dwayne Omar Ennis Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 20646 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LA PLATA, MD 20646
LA PLATA, MD 20646
LA PLATA, MD 20646
LA PLATA, MD 20646
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 Dwayne Ennis's NPI number?
The NPI number for Dwayne Ennis is 1700607835. It was assigned to this individual provider in the NPPES registry on October 21, 2024.
Where is Dwayne Ennis located?
Dwayne Ennis practices at 1014 Washington Ave, La Plata, MD 20646. The listed phone number is (917) 560-5145.
What is Dwayne Ennis's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Dwayne Ennis enrolled in Medicare?
Yes. Dwayne Ennis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Dwayne Ennis was last updated on February 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.
# Dwayne Omar Ennis, PMHNP-BC · NPI 1700607835
Psychiatric/Mental Health physician in La Plata, Maryland. Individual provider, active in the CMS NPPES registry since October 21, 2024.
## Identity
- **NPI:** 1700607835 (Entity type: Individual)
- **Enumerated:** October 21, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** R173805 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 1014 WASHINGTON AVE, La Plata, MD 20646-4228
- **Phone:** (917) 560-5145
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** February 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1700607835) · Data from the CMS NPPES public registry.