Individual provider Active NPI

Odunayo Abiodun Obisesan, PHARM.D, CGP

  • Pharmacist
  • Washington, DC
National Provider Identifier
1265641971
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH2389 Issued in DC
Practice address
2041 Georgia Ave NW
Suite BB06
Washington, DC 20060-0001
Phone
(202) 865-7415
Fax
(202) 865-7410
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH2389 DC Primary

Addresses

Primary practice location

2041 Georgia Ave NW
Suite BB06
Washington, DC 20060-0001

Mailing address

13465 Sorghum CT
Suite 1
Highland, MD 20777-9756
Phone (301) 768-4935

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH2389DCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265641971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13465 SORGHUM CT",
            "address_2": "SUITE 1",
            "city": "HIGHLAND",
            "state": "MD",
            "postal_code": "207779756",
            "telephone_number": "301-768-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVE NW",
            "address_2": "SUITE BB06",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001",
            "telephone_number": "202-865-7415",
            "fax_number": "202-865-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBISESAN",
        "first_name": "ODUNAYO",
        "middle_name": "ABIODUN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D, CGP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DC",
            "license": "PH2389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

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.