Active NPI
Christianah T Olufade
- Psychiatric/Mental Health Nurse Practitioner
- College Park, MD
National Provider Identifier
1225650872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- R185400
- Practice address
- 4920 Niagara Rd Ste 107
College Park, MD 20740-1121 - Phone
- (301) 755-7685
- NPI assigned
- May 16, 2020
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R185400 | MD | Primary |
Addresses
Primary practice location
4920 Niagara Rd Ste 107
College Park, MD 20740-1121
Mailing address
4920 Niagara Rd Ste 107
College Park, MD 20740-1121
Phone (301) 755-7685
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589587200000",
"number": "1225650872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4920 NIAGARA RD STE 107",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207401121",
"telephone_number": "301-755-7685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4920 NIAGARA RD STE 107",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207401121",
"telephone_number": "301-755-7685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLUFADE",
"first_name": "CHRISTIANAH",
"middle_name": "T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-16",
"last_updated": "2020-05-16",
"certification_date": "2020-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MD",
"license": "R185400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2020; 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.