NPIMap

Organization Active NPI

Genesis Healthcare Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Randallstown, MD
National Provider Identifier
1265295125
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GENESIS HEALTHCARE INC
Doing business as
Genesis Healthcare Inc
Practice address
8509 Glen Michael LN Apt T3
Randallstown, MD 21133-5227
Phone
(410) 258-0565
NPI assigned
Feb 2, 2024
Last updated
May 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Dr. Bolaji Olugboja, DNP PMHNPNPI 1689005043
Title
Medical Director
Phone
(410) 258-0565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary
Psychiatry Physician 2084P0800X NU
Addiction Psychiatry Physician 2084P0802X NU

Addresses

Primary practice location

8509 Glen Michael LN Apt T3
Randallstown, MD 21133-5227

Mailing address

127 Pittston Cir
Owings Mills, MD 21117-1723
Phone (410) 258-0565

Other names 1

  • Genesis Healthcare Inc Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1265295125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 PITTSTON CIR",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171723",
            "telephone_number": "410-258-0565",
            "fax_number": "410-237-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8509 GLEN MICHAEL LN APT T3",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335227",
            "telephone_number": "410-258-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "OLUGBOJA",
        "authorized_official_first_name": "BOLAJI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-258-0565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Healthcare Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Genesis Healthcare Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.