Mary Alice Olds, CRNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R199404 Issued in MD

Practice address

4775 Ilkley Moor LN
Ellicott City, MD 21043-6531

Phone

(443) 904-2099

NPI assigned

Jun 22, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Personic Virtual Clinic LLC

  • Wound Care Registered Nurse
  • Elkridge, MD
  • NPI 1740878420
  Medicare reassignment
• American Wound Care PC

  • Wound Care Registered Nurse
  • Elkridge, MD
  • NPI 1316799638
  NPD (past)

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1154007409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 ILKLEY MOOR LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436531",
            "telephone_number": "443-904-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 ILKLEY MOOR LN",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436531",
            "telephone_number": "443-904-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDS",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "R199404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Ogunmuyiwa, REGISTERED NURSE
• Mary-Jane Ebere Ojie-Badger, PHD
• Juliet Adaobi Okeke
• Catherine Foluke Okoloise, LPN
• Raliat Oyinlola Ola-Dauda, PHARMD
• Thomasina Oleary, APRN
• Omega Health Care, LLC
• Faith Itohan Omoregie, RN
• Rachel Ondrish, NP
• One Heart LLC

• Family Medicine Physician in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.