Individual provider Active NPI

Tolulope Adegbore, PT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1174734784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21957 Issued in MD
Practice address
2434 W Belvedere Ave
Baltimore, MD 21215-5202
Phone
(401) 601-2255
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
No

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21957MDMDPhysical Therapist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 21957 MD Primary

Addresses

NPPES NPI Registry

Primary practice location

2434 W Belvedere Ave
Baltimore, MD 21215-5202

Mailing address

2005 Magnolia Woods CT
Unit K
Edgewood, MD 21040-1619
Phone (617) 407-7922

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174734784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 MAGNOLIA WOODS CT",
            "address_2": "UNIT K",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401619",
            "telephone_number": "617-407-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155202",
            "telephone_number": "401-601-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEGBORE",
        "first_name": "TOLULOPE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.