Rejuvaris

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

REJUVARIS

Doing business as

Rejuvaris

Practice address

9635 Liberty Rd
Randallstown, MD 21133-2436

Phone

(410) 929-4790

NPI assigned

Aug 12, 2025

Last updated

Aug 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Abisola Alade, DNP,CRNPNPI 1972140242

Title

Nurse Practitioner

Phone

(410) 929-4790

Specialties & licenses 1

Addresses

Other names 1

• Rejuvaris Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Abisola Omowumi Alade, CRNP

  • Adult Medicine Physician
  • Randallstown, MD
  • NPI 1972140242
  NPD Authorized official

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754956800000",
    "number": "1417833856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9635 LIBERTY RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332436",
            "telephone_number": "410-929-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9635 LIBERTY RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332436",
            "telephone_number": "410-929-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVARIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "ALADE",
        "authorized_official_first_name": "ABISOLA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "410-929-4790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP,CRNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rejuvaris",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebekah Home Healthcare, LLC
• Rebekah Home Healthcare, LLC
• Rebekah Home Healthcare, LLC
• Rebekah Home Healthcare,LLC
• Samantha Reich, LCSW-C
• Reliable Assisted Living and Training
• Reliable Assisted Living and Training
• Remac Support Services, Inc
• Restoration Healthcare Inc.
• Robert Lee Rhodes Jr., L.CSW-C

• Primary Care Clinic/Center in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Primary Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.