Active NPI
Odunlade Olalere, CRNP
- Pediatric Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1366710444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- R170771
- Practice address
- 175 W Ostend St Ste 102
Baltimore, MD 21230-3792 - Phone
- (410) 697-5357
- Fax
- (410) 457-9626
- NPI assigned
- Dec 5, 2011
- Last updated
- Jun 14, 2024
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R170771 | MD | Primary |
Addresses
Primary practice location
175 W Ostend St Ste 102
Baltimore, MD 21230-3792
Mailing address
175 W Ostend St Ste 102
Baltimore, MD 21230-3792
Phone (410) 697-5357
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 335165300 | 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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kinderhealth, LLC | Pediatrics | Current | Accepting new patients |
Locations
10 W West St
Baltimore, MD 21230
175 W Ostend St
Ste 102
Baltimore, MD 21230
Phone (410) 697-5357
2411 W Belvedere Ave
Ste 303
Baltimore, MD 21215
Phone (410) 466-4700
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
- o.odunlade@kl-md.direct.office.nextgen.com
Organizations & group practices 1
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": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1366710444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 W OSTEND ST STE 102",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212303792",
"telephone_number": "410-697-5357",
"fax_number": "410-457-9626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 W OSTEND ST STE 102",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212303792",
"telephone_number": "410-697-5357",
"fax_number": "410-457-9626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLALERE",
"first_name": "ODUNLADE",
"name_prefix": "Ms.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-05",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MD",
"license": "R170771",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "335165300",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.