Blossom Care and Behavioral Services Inc

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BLOSSOM CARE AND BEHAVIORAL SERVICES INC

Practice address

15601 Peach Orchard Way
Bowie, MD 20716-1543

Phone

(202) 415-0285

NPI assigned

May 29, 2020

Last updated

May 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wakeelat A Adeoye, PMHNP-BCNPI 1497317853

Title

President

Phone

(202) 415-0285

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Blossom Care and Behavioral Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1508508227

  O20230731001343

  Same enrollment

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wakeelat A Adeoye

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1497317853

  DC

  Medicare reassignment Authorized official
• Lilian Kusona, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1447678180
  Medicare reassignment NPD
• Sunny Lambert

  • Psychiatric/Mental Health Nurse Practitioner
  • Upper Marlboro, MD
  • NPI 1760251268
  Medicare reassignment NPD

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1043834757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15601 PEACH ORCHARD WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161543",
            "telephone_number": "202-415-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15601 PEACH ORCHARD WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161543",
            "telephone_number": "202-415-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM CARE AND BEHAVIORAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "ADEOYE",
        "authorized_official_first_name": "WAKEELAT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-415-0285",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Bowie, MD
• Providers in Bowie, 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 May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.