Individual provider Active NPI

Kolapo Idowu, MBBS

  • Family Medicine Physician
  • Odenton, MD
National Provider Identifier
1285020867
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D85313 Issued in MD
Practice address
1132 Annapolis Rd # 310
Odenton, MD 21113-1647
Phone
(443) 367-4740
NPI assigned
Apr 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X D85313 MD Primary

Addresses

Primary practice location

1132 Annapolis Rd # 310
Odenton, MD 21113-1647

Mailing address

9910 Franklin Square Dr # 2110
Baltimore, MD 21236-4902
Phone (410) 933-5412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180727001786 MD Practitioner - Family Practice 3476800038 Reassigns benefits to 2 organizations
I20180730003379 DC Practitioner - Internal MedicinePractitioner - Family Practice 3476800038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 E Eager St
E Baltimore Med Ctr
Baltimore, MD 21202-5533
Phone (410) 522-9800

1106 Annapolis Rd
Suite 310
Odenton, MD 21113-1744
Phone (410) 874-1400

7575 E Howard Rd
Marley Neck Rehab
Glen Burnie, MD 21060-8312
Phone (410) 768-8200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians CurrentSince Jul 16, 2018 Accepting new patients
Johns Hopkins Community Physicians, Inc CurrentSince Jul 16, 2018 Accepting new patients
Johns Hopkins Community Physicians, Inc CurrentSince Jul 16, 2018 Accepting new patients
Ivana Healthcare Services, Inc CurrentSince May 12, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

7575 E Howard Rd
Glen Burnie, MD 21060
Phone (410) 760-0068

14207 Park Center Dr
Ste 102
Laurel, MD 20707
Phone (301) 604-5254

9910 Franklin Square Dr
#2110
Nottingham, MD 21236
Phone (410) 933-5412

1132 Annapolis Rd
#310
Odenton, MD 21113
Phone (443) 367-4740

Interoperability endpoints

  • Direct secure messaging: kidowu456563@direct.hopkinsmedicine.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1285020867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR # 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 ANNAPOLIS RD # 310",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211131647",
            "telephone_number": "443-367-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDOWU",
        "first_name": "KOLAPO",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D85313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odenton, MD

Sources for this page

Verify at the official NPI Registry.