Individual provider Active NPI

Gbenga Isaac Olajide, R.PH.

  • Pharmacist
  • Baltimore, MD
National Provider Identifier
1376660993
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13190 Issued in MD
Practice address
2021 W Pratt St
Baltimore, MD 21223-2242
Phone
(410) 566-1360
Fax
(410) 566-5088
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13190 MD Primary

Addresses

Primary practice location

2021 W Pratt St
Baltimore, MD 21223-2242

Mailing address

5901 Norway CT
Columbia, MD 21044-5732
Phone (410) 566-1360

Other identifiers 1

IdentifierTypeStateIssuer
13190OtherMDBOARD LICENCE

Other names 1

  • Mr. Gbenga Isaac Olajide Professional name

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
13190MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Ventures, Inc Past Accepting new patients
Mid-Atlantic Ventures, Inc PastSince Nov 29, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1376660993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 NORWAY CT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210445732",
            "telephone_number": "410-566-1360",
            "fax_number": "410-566-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 W PRATT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232242",
            "telephone_number": "410-566-1360",
            "fax_number": "410-566-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAJIDE",
        "first_name": "GBENGA",
        "middle_name": "ISAAC",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "13190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD LICENCE",
            "identifier": "13190",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GBENGA",
            "last_name": "OLAJIDE",
            "middle_name": "ISAAC",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.