Organization Active NPI

Medcity Family Clinic LLC

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1093482705
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MEDCITY FAMILY CLINIC LLC
Doing business as
Medcity Family Clinic LLC
Practice address
2509 Washington Blvd
Baltimore, MD 21230-1406
Phone
(443) 565-2408
NPI assigned
Aug 30, 2021
Last updated
Aug 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Faith Olubukola AdebuleNPI 1306404058
Title
Ceo
Phone
(443) 623-3592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

2509 Washington Blvd
Baltimore, MD 21230-1406

Mailing address

2509 Washington Blvd
Baltimore, MD 21230-1406
Phone (443) 835-4228

Other names 1

  • Medcity Family Clinic LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210915001739 MD Part B Supplier - Clinic/Group Practice 4486050556 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2255107Medcity Family Clinic LLC2509 Washington Blvd Floor 1, Baltimore, MD 21230Certificate of waiverMar 9, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2509 Washington Blvd
#1
Baltimore, MD 21230
Phone (443) 565-2408

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24961/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1093482705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 WASHINGTON BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212301406",
            "telephone_number": "443-835-4228",
            "fax_number": "301-369-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 WASHINGTON BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212301406",
            "telephone_number": "443-565-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCITY FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-30",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "ADEBULE",
        "authorized_official_first_name": "FAITH",
        "authorized_official_middle_name": "OLUBUKOLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-623-3592"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medcity Family Clinic LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.