Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dwayne Omar Ennis, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1700607835

Dwayne Omar Ennis, PMHNP-BC is a Nurse Practitioner in LA Plata, Maryland. Qualified in 2014, 12 years ago. Practices with Axis Healthcare Group, a 74-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
12
Licensed in
MD
In the registry since
2024
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

1014 Washington Ave
LA Plata, MD 20646-4228
Phone: (917) 560-5145
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8040 Georgia Ave Ste 170, Silver Spring, MD 20910-4959 — (202) 360-4787

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence R173805 (MD)

Record details

NPI number1700607835
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedOctober 21, 2024
Last updated in NPPESFebruary 6, 2026
Certification dateFebruary 6, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Axis Healthcare Group — 74 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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