Individual provider Active NPI

Kehinde Oyekan, CPMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Reisterstown, MD
National Provider Identifier
1497390413
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024181173 Issued in VA
Practice address
244 Persimmon Cir
Reisterstown, MD 21136-6464
Phone
(918) 851-3736
NPI assigned
Nov 13, 2019
Last updated
Apr 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R193468 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024181173 VA Primary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X R193468 MD

Addresses

Primary practice location

244 Persimmon Cir
Reisterstown, MD 21136-6464

Mailing address

201 E University Pkwy
Baltimore, MD 21218-2829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201217000710 MD Practitioner - Nurse Practitioner 1355753211 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R193468MDMDPsychiatric/Mental Health Nurse Practitioner
0024181173VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Wellness Center, LLC CurrentSince Aug 27, 2020 Accepting new patients

Locations

210 W Pennsylvania Ave
Ste 100
Towson, MD 21204
Phone (443) 201-1991

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, 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": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1497390413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E UNIVERSITY PKWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 PERSIMMON CIR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366464",
            "telephone_number": "918-851-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYEKAN",
        "first_name": "KEHINDE",
        "credential": "CPMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R193468",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024181173",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MD",
            "license": "R193468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

Verify at the official NPI Registry.