The Lily Valley Group, Inc.

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

THE LILY VALLEY GROUP, INC.

Doing business as

Lily Health and Wellness Center

Practice address

1600 Belle Dr
Annapolis, MD 21401-1147

Phone

(240) 401-5260

NPI assigned

Mar 2, 2022

Last updated

Oct 28, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

THE LILY VALLEY GROUP, INC.As reported in NPPES

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

Authorized official

Name

Dr. Similade Adetunji, DNP, PMHNP,FNPNPI 1073155248

Title

Provider

Phone

(240) 401-5260

Specialties & licenses 2

Addresses

Other names 1

• Lily Health and Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Enrollment records 2

Tax ID family

The Lily Valley Group Inc2 organizations share this tax ID, including this one

Part of

The Lily Valley Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Lily Valley Group, Inc.

  dba Lily Health and Wellness Center

  • Family Nurse Practitioner
  • Annapolis, MD
  • NPI 1679287452
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• The Lily Valley Group, Inc.

  dba Lily Health and Wellness Center

  • Family Nurse Practitioner
  • Annapolis, MD
  • NPI 1679287452
  NPPES parent name

Practitioners 2

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.

• Similade Adetunji

  • Psychiatric/Mental Health Nurse Practitioner
  • Annapolis, MD
  • NPI 1073155248

  DC, Family

  Medicare reassignment NPD Authorized official
• Michael Bojerenu, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Annapolis, MD
  • NPI 1235925348
  NPD

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698451200000",
    "number": "1053067876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 BELLE DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011147",
            "telephone_number": "240-401-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 BELLE DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011147",
            "telephone_number": "240-401-5260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 Connecticut Ave NW Ste 700",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200362657",
            "country_code": "US",
            "telephone_number": "240-401-5260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE LILY VALLEY GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE LILY VALLEY GROUP, INC.",
        "enumeration_date": "2022-03-02",
        "last_updated": "2023-10-28",
        "certification_date": "2023-10-28",
        "status": "A",
        "authorized_official_last_name": "ADETUNJI",
        "authorized_official_first_name": "SIMILADE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "240-401-5260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, PMHNP,FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lily Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lily Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Annapolis, MD
• Providers in Annapolis, 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 Oct 28, 2023; 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.