Individual provider Active NPI

Lanre Tajudeen Akinkunmi, M.D

  • Family Medicine Physician
  • Elkton, MD
National Provider Identifier
1255413969
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD429647 Issued in PA
Practice address
111 W High St
Suite 314
Elkton, MD 21921-5529
Phone
(410) 398-4679
NPI assigned
Oct 20, 2006
Last updated
Sep 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD429647 PA Primary

Addresses

Primary practice location

111 W High St
Suite 314
Elkton, MD 21921-5529

Mailing address

111 W High St
Suite 314
Elkton, MD 21921-5529
Phone (410) 398-4679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000713 MD Practitioner - Family Practice 1052319100 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD429647PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County Family Medicine CurrentSince Sep 1, 2010 Accepting new patients
Christiana Care Quality Partners CurrentSince Jun 13, 2021 Accepting new patients
Union Hospital of Cecil County CurrentSince Sep 1, 2010 Accepting new patients

Locations

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

111 W High St
Ste 314
Elkton, MD 21921
Phone (410) 398-4510

123 Singerly Ave
Elkton, MD 21921
Phone (410) 392-2686

210 Chesapeake Blvd
Elkton, MD 21921

310 E Pulaski Hwy
Elkton, MD 21921
Phone (443) 485-6213

101 North East Plz
North East, MD 21901
Phone (410) 543-2020

Organizations & group practices 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1255413969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W HIGH ST",
            "address_2": "SUITE 314",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215529",
            "telephone_number": "410-398-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W HIGH ST",
            "address_2": "SUITE 314",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215529",
            "telephone_number": "410-398-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKINKUNMI",
        "first_name": "LANRE",
        "middle_name": "TAJUDEEN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD429647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.