Individual provider Active NPI

Adebola A Adejuwon, NP

  • Family Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1174089239
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R220058 Issued in MD
Practice address
178 Thomas Johnson Dr
Frederick, MD 21702-4386
Phone
(301) 673-1901
NPI assigned
Feb 13, 2019
Last updated
May 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R220058 MD Primary
Family Nurse Practitioner 363LF0000X RN1033944 DC

Addresses

Primary practice location

178 Thomas Johnson Dr
Frederick, MD 21702-4386

Mailing address

178 Thomas Johnson Dr Ste 204L
Frederick, MD 21702-4352
Phone (301) 673-1901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190822002570 MD Practitioner - Nurse Practitioner 3779811146 Reassigns benefits to 2 organizations
I20210819001415 DC Practitioner - Nurse Practitioner 3779811146

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1033944DCMDFamily Nurse Practitioner
R220058MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matclinic Physicians Practice Group LLC CurrentSince Aug 11, 2020 Accepting new patients
Matclinic Physicians Practice Group LLC CurrentSince May 15, 2021 Accepting new patients
Matclinic Physicians Practice Group LLC CurrentSince Aug 11, 2020 Accepting new patients
Center for Pain Management, LLC CurrentSince Jun 23, 2019 Accepting new patients
Vertex Health LLC Past Accepting new patients

Locations

940 Seton Dr
Cumberland, MD 21502
Phone (301) 777-2543

40 S Dundalk Ave
Ste 400
Dundalk, MD 21222
Phone (410) 220-0270

1600 Crain Hwy S
Ste 301
Glen Burnie, MD 21061
Phone (410) 760-1400

1150 Professional Ct
Ste P
Hagerstown, MD 21740
Phone (301) 665-9696

11350 McCormick Rd
Ste 501
Hunt Valley, MD 21031
Phone (410) 329-1071

601 7th St
Ste 304
Laurel, MD 20707
Phone (410) 220-0280

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1174089239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 THOMAS JOHNSON DR STE 204L",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024352",
            "telephone_number": "301-673-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024386",
            "telephone_number": "301-673-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEJUWON",
        "first_name": "ADEBOLA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R220058",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1033944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.