Active NPI
Olayiwola Williams
- Home Health Aide
- Gwynn Oak, MD
National Provider Identifier
1356930440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- R4645
- Practice address
- 3508 Rhom Rd
Gwynn Oak, MD 21207-5768 - Phone
- (443) 813-4457
- NPI assigned
- Jan 13, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | R4645 | MD | Primary |
Addresses
Primary practice location
3508 Rhom Rd
Gwynn Oak, MD 21207-5768
Mailing address
3508 Rhom Rd
Gwynn Oak, MD 21207-5768
Phone (443) 813-4457
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 799240800 | Medicaid | MD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R4645 | MD | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610496000000",
"number": "1356930440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3508 RHOM RD",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "212075768",
"telephone_number": "443-813-4457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3508 RHOM RD",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "212075768",
"telephone_number": "443-813-4457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "OLAYIWOLA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-13",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MD",
"license": "R4645",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "799240800",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gwynn Oak, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.