Adebola O Adeleye, DNP, APN-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R194885 Issued in MD

Practice address

4390 Montgomery Rd
Attn: Minuteclinic Credentialing 2100
Ellicott City, MD 21043-6068

Phone

(410) 203-1700

NPI assigned

Mar 8, 2011

Last updated

Feb 8, 2017By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1033417555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4390 MONTGOMERY RD",
            "address_2": "ATTN: MINUTECLINIC CREDENTIALING 2100",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436068",
            "telephone_number": "410-203-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 MONTGOMERY RD",
            "address_2": "ATTN: MINUTECLINIC CREDENTIALING 2100",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436068",
            "telephone_number": "410-203-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELEYE",
        "first_name": "ADEBOLA",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DNP, APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R194885",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00317000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.