Rose Godwin Support Services, Inc

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ROSE GODWIN SUPPORT SERVICES, INC

Practice address

13671 Baltimore Ave
Laurel, MD 20707-5096

Phone

(301) 907-1700

Fax

(877) 714-8747

NPI assigned

Sep 23, 2020

Organization subpart

No

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

Authorized official

Name

Ayo OkoroNPI 1972841856

Title

Nurse Practitioner

Phone

(301) 907-1700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, GA, WV3 enrollments

Enrollment records 3

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Rose Godwin Support Services, Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Beltsville, MD
  • NPI 1053890111

  9234488305

  Same PAC ID

Practitioners 2

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

• Ayo Okoro, FAMILY NURSE PRACTIT

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
  • NPI 1972841856

  GA, WV

  Medicare reassignment Authorized official
• Rasidat Folasade Akinyemi, FNP

  • Family Nurse Practitioner
  • Upper Marlboro, MD
  • NPI 1134013626
  NPD

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1487260584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11226 CHERRY HILL RD APT 302",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207053831",
            "telephone_number": "301-907-1700",
            "fax_number": "877-714-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13671 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075096",
            "telephone_number": "301-907-1700",
            "fax_number": "877-714-8747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13671 Baltimore Ave",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207075096",
            "country_code": "US",
            "telephone_number": "301-907-1700",
            "fax_number": "877-714-8747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROSE GODWIN SUPPORT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "OKORO",
        "authorized_official_first_name": "AYO",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "301-907-1700"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Josette Ronsheim
• Rooted Growth Wellness, LLC
• Rosales and Associates
• Kimberly Ann Rosales, LCSW-C
• Rian Mycal Rosario-Heredia
• Stacie L Rose-Dixon, M.ED.
• Latonya Rose, LMSW
• Sarah Rose
• Milord Roseborough, RDH
• Melanie Rosen

• Psychiatric/Mental Health Nurse Practitioner in Laurel, MD
• Providers in Laurel, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.