Active NPI
Omobolanle M. Adenuga, CRNP-F
- Nurse Practitioner
- Ellicott City, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R214177
- Practice address
- 3565 Ellicott Mills Dr Ste B2
Ellicott City, MD 21043-4549 - Phone
- (443) 282-3413
- Fax
- (443) 276-7475
- NPI assigned
- Aug 22, 2019
- Last updated
- Jan 20, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R214177 | MD | Primary |
Addresses
Primary practice location
3565 Ellicott Mills Dr Ste B2
Ellicott City, MD 21043-4549
Mailing address
3565 Ellicott Mills Dr Ste B2
Ellicott City, MD 21043-4549
Phone (443) 272-5506
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, VA, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Memorial Ave
Westminster, MD 21157-5726
Phone (410) 871-6700
3565 Ellicott Mills Dr
Suite B2
Ellicott City, MD 21043-4549
Phone (443) 282-3413
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R214177 | MD | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mep Observation Services LLC | Nurse Practitioner | Current | Accepting new patients |
| CRH MD Management LLC | Current | Accepting new patients | |
| Mep Observation Services LLC | Current | Accepting new patients | |
| CRH MD Management LLC | Current | Accepting new patients | |
| CRH MD Management, LLC | Current | Accepting new patients |
Locations
590 Lanier Ave W
Fayetteville, GA 30214
14421 Baltimore Ave
Laurel, MD 20707
Phone (240) 786-6684
5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727
11804 Reisterstown Rd
Reisterstown, MD 21136
Phone (410) 870-5094
14090 Hg Trueman Rd
Ste 1300
Solomons, MD 20688
Phone (410) 394-2800
Organizations & group practices 8
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.
-
- Clinic/Center
- Ellicott City, MD
- NPI 1053959411
-
- Emergency Medicine Physician
- Falls Church, VA
- NPI 1134117393
MD
-
dba Patriot Urgent Care
- Urgent Care Clinic/Center
- Reisterstown, MD
- NPI 1598435059
DC
-
- Emergency Medicine Physician
- Cumberland, MD
- NPI 1093003550
Nurse Practitioner
-
- Family Nurse Practitioner
- Leesburg, VA
- NPI 1417076829
-
dba Patriot Urgent Care
- Urgent Care Clinic/Center
- Fort Washington, MD
- NPI 1841072477
-
- Internal Medicine Physician
- Rockville, MD
- NPI 1740021625
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Westminster, MD
- NPI 1912904210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768867200000",
"number": "1336796465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3565 ELLICOTT MILLS DR STE B2",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210434549",
"telephone_number": "443-272-5506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3565 ELLICOTT MILLS DR STE B2",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210434549",
"telephone_number": "443-282-3413",
"fax_number": "443-276-7475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADENUGA",
"first_name": "OMOBOLANLE",
"middle_name": "M.",
"credential": "CRNP-F",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-22",
"last_updated": "2026-01-20",
"certification_date": "2026-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MD",
"license": "R214177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.