Oluwatoyin Clara Adisa, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R142566 Issued in MD

Practice address

3425 Sinclair LN
Baltimore, MD 21213-2030

Phone

(410) 366-1151

Fax

(410) 366-1151

NPI assigned

Feb 13, 2009

Last updated

Mar 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Oluwatoyin Clara Adisa Professional name

Medicare fee-for-service enrollment

Enrolled in MD

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifebridge Primary Care of North Carroll, LLC

  dba Carroll Medical Group

  • Family Medicine Physician
  • Hampstead, MD
  • NPI 1811398175
  Medicare reassignment NPD
• Post Acute Physician Partners, LLC

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1710385554
  Medicare reassignment NPD
• Sage Hollow Health PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
  • NPI 1003700071
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1013156181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4534 OLD COURT RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082430",
            "telephone_number": "443-629-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 SINCLAIR LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132030",
            "telephone_number": "410-366-1151",
            "fax_number": "410-366-1151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4726 Avatar Ln",
            "address_purpose": "LOCATION",
            "city": "Owings Mills",
            "state": "MD",
            "postal_code": "211177400",
            "country_code": "US",
            "telephone_number": "443-629-2282",
            "fax_number": "443-629-2282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADISA",
        "first_name": "OLUWATOYIN",
        "middle_name": "CLARA",
        "name_prefix": "Mrs.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024171618",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "DC",
            "license": "RN68175",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R142566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLUWATOYIN",
            "last_name": "ADISA",
            "middle_name": "CLARA",
            "prefix": "MRS.",
            "credential": "ACNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shakirat Adigun
• Zainab Yinka Adigun
• Vijay Venkata Adimoolam, MD
• Adio Chiropractic, Inc (Michael J Martin, Dc)
• Oluwadamilola Nurude Adisa
• Dora Adjei
• Stephanie Adjei, MD
• Christine Adjoodani
• Adjustablebedsandmobility LLC
• Adjuvant Behavioral Health Inc

• Acute Care Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Acute Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.