Individual provider Active NPI

Nora Nwakego Agajelu, CRNP

  • Adult Health Nurse Practitioner
  • Glen Burnie, MD
National Provider Identifier
1053589028
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R174033 Issued in MD
Practice address
85 Kindred Way
Apt 101
Glen Burnie, MD 21061-5246
Phone
(410) 553-6360
Fax
(410) 553-6661
NPI assigned
Feb 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R174033 MD
Gerontology Nurse Practitioner 363LG0600X R174033 MD
Adult Health Nurse Practitioner 363LA2200X R174033 MD Primary

Addresses

Primary practice location

85 Kindred Way
Apt 101
Glen Burnie, MD 21061-5246

Mailing address

85 Kindred Way
Apt 101
Glen Burnie, MD 21061-5246
Phone (410) 553-6360

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111103000500 MD Practitioner - Nurse Practitioner 1254504434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nnaemeka Agajelu MD LLC CurrentSince Feb 21, 2018 Accepting new patients

Locations

85 Kindred Way
Apt 101
Glen Burnie, MD 21061
Phone (410) 553-6360

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAIICA/Endpoint/EAIICA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1053589028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 KINDRED WAY",
            "address_2": "APT 101",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615246",
            "telephone_number": "410-553-6360",
            "fax_number": "410-553-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 KINDRED WAY",
            "address_2": "APT 101",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615246",
            "telephone_number": "410-553-6360",
            "fax_number": "410-553-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAJELU",
        "first_name": "NORA",
        "middle_name": "NWAKEGO",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R174033",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R174033",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R174033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.