NPIMap

Organization Active NPI

Access Family Practice and Walk-in Clinic

  • Primary Care Clinic/Center
  • Windsor Mill, MD
National Provider Identifier
1447582267
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ACCESS FAMILY PRACTICE AND WALK-IN CLINIC
Practice address
3110 N Rolling Rd
Windsor Mill, MD 21244-2023
Phone
(410) 298-1931
Fax
(410) 298-1932
NPI assigned
Feb 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Dr. Modupe Debra Togun, DNP, FNP-BC, PMHNPNPI 1033340278
Title
Medical Officer
Phone
(410) 963-3993

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

3110 N Rolling Rd
Windsor Mill, MD 21244-2023

Mailing address

3110 N Rolling Rd
Windsor Mill, MD 21244-2023
Phone (410) 298-1931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101021000610 MD Part B Supplier - Clinic/Group Practice 5597958694 Receives reassigned benefits from 1 practitioner
Practice locations: Windsor Mill, MD

National Provider Directory

National Provider Directory

Locations

2324 N Rolling Rd
Ste 101
Windsor Mill, MD 21244
Phone (410) 298-1931

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1447582267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 N ROLLING RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442023",
            "telephone_number": "410-298-1931",
            "fax_number": "410-298-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 N ROLLING RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442023",
            "telephone_number": "410-298-1931",
            "fax_number": "410-298-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS FAMILY PRACTICE AND WALK-IN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "TOGUN",
        "authorized_official_first_name": "MODUPE",
        "authorized_official_middle_name": "DEBRA",
        "authorized_official_title_or_position": "MEDICAL OFFICER",
        "authorized_official_telephone_number": "410-963-3993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP-BC, PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.