Individual provider Active NPI

Risikat A Afolabi-Zannu

  • Psychiatric/Mental Health Nurse Practitioner
  • Upper Marlboro, MD
National Provider Identifier
1336805084
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R116607 Issued in MD
Practice address
7608 Georgian Dr
Upper Marlboro, MD 20772-4496
Phone
(240) 449-9174
NPI assigned
Nov 16, 2021
Last updated
Sep 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R116607 MD Primary

Addresses

Primary practice location

7608 Georgian Dr
Upper Marlboro, MD 20772-4496

Mailing address

7608 Georgian Dr
Upper Marlboro, MD 20772-4496
Phone (240) 449-9174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920000340 DC Practitioner - Nurse Practitioner 2567721913 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R116607MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health (Including Community Mental Health Center) CurrentSince Jul 5, 2024 Accepting new patients
Daja Health, LLC CurrentSince Jun 24, 2024 Accepting new patients
Daja Health, LLC Current Accepting new patients
Supreme Healthcare Services, LLC PastSince Nov 21, 2021 Accepting new patients

Locations

6305 Ivy Ln
Ste 260
Greenbelt, MD 20770
Phone (202) 670-7703

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

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, 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": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1336805084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7608 GEORGIAN DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207724496",
            "telephone_number": "240-449-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7608 GEORGIAN DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207724496",
            "telephone_number": "240-449-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFOLABI-ZANNU",
        "first_name": "RISIKAT",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2023-09-12",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R116607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

Verify at the official NPI Registry.