Active NPI
Busola O Odubayo, DPT
- Physical Therapist
- Silver Spring, MD
National Provider Identifier
1164063939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 27348
- Practice address
- 13210 Redspire Dr
Silver Spring, MD 20906-6739 - Phone
- (123) 123-1234
- NPI assigned
- Oct 3, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 27348 | MD | Primary |
Addresses
Primary practice location
13210 Redspire Dr
Silver Spring, MD 20906-6739
Mailing address
13210 Redspire Dr
Silver Spring, MD 20906-6739
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27348 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1164063939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13210 REDSPIRE DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209066739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13210 REDSPIRE DR",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209066739",
"telephone_number": "123-123-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODUBAYO",
"first_name": "BUSOLA",
"middle_name": "O",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-03",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "27348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.