Adedayo Temitope Omobo, CRNP-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R174545 Issued in MD

Practice address

10999 Red Run Blvd Ste 205
Owings Mills, MD 21117-3249

Phone

(240) 462-7690

NPI assigned

Apr 19, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sound Wellness CenterGroup PAC ID 8022487156, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Sound Wellness Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Owings Mills, MD
  • NPI 1861082752
  Medicare reassignment Care Compare group
• Magnify Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1720891252
  Medicare reassignment NPD
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483

  DC

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1003497215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12906 MAYFLOWER PL",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207203368",
            "telephone_number": "240-462-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10999 RED RUN BLVD STE 205",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173249",
            "telephone_number": "240-462-7690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3611 Branch Ave Ste 309",
            "address_purpose": "LOCATION",
            "city": "Temple Hills",
            "state": "MD",
            "postal_code": "207481242",
            "country_code": "US",
            "telephone_number": "240-413-9291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMOBO",
        "first_name": "ADEDAYO",
        "middle_name": "TEMITOPE",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R174545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Solomon Oliver, DPT
• Valderas Barksdale Oliver, LCPC
• Inna Olshansky, OTR
• Noryor Toritseju Omatseye
• Omega Access Services LLC
• Kolade Benson Omoyeni, MBA
• One Step Further Mental Health Rehabilitation Program LLC
• Bruno Opara
• Crystal Delenous Opasina
• Augustina Olajumoke Opeewe-Ojo, APRN

• Psychiatric/Mental Health Nurse Practitioner in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.