Individual provider Active NPI

Bukola Elizabeth Owolabi

  • Nurse's Aide
  • Hyattsville, MD
National Provider Identifier
1235704370
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
A00177242 Issued in MD
Practice address
2404 Virginia Ave Apt 102
Hyattsville, MD 20785-3376
Phone
(929) 355-9746
NPI assigned
May 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X A00177242 MD Primary

Addresses

Primary practice location

2404 Virginia Ave Apt 102
Hyattsville, MD 20785-3376

Mailing address

2404 Virginia Ave Apt 102
Hyattsville, MD 20785-3376

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
A00177242MDMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1235704370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 VIRGINIA AVE APT 102",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207853376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 VIRGINIA AVE APT 102",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207853376",
            "telephone_number": "929-355-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWOLABI",
        "first_name": "BUKOLA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MD",
            "license": "A00177242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.