Oluwatosin A Fanimo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R183671 Issued in MD

Practice address

2000 W Baltimore St
Baltimore, MD 21223-1558

Phone

(202) 246-3013

NPI assigned

May 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Assured Access Medical Associates Inc.

  • General Practice Physician
  • Greenbelt, MD
  • NPI 1720623242
  NPD
• Charles County Department of Health

  • Community/Behavioral Health Agency
  • White Plains, MD
  • NPI 1033564638
  NPD
• Charles County Health Department

  • Public Health or Welfare Agency
  • White Plains, MD
  • NPI 1841377728
  NPD
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483
  NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1556928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556928000000",
    "number": "1538724604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 N POINT LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082356",
            "telephone_number": "202-246-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212231558",
            "telephone_number": "202-246-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANIMO",
        "first_name": "OLUWATOSIN",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-04",
        "last_updated": "2019-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R183671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ming Fang, M.D.
• Raymond Fang, M.D.
• Wei Han Fang, MD
• Michelle Fanga
• Jaimie Fangman, PTA
• Nicole Suzanne Fanning, M.D.
• Cynthia Ann Fannon, AUD
• Kathleen Fanone, LCSW-C
• Hamsun Fanord
• Tensae Fantahun

• Psychiatric/Mental Health Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, 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 May 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.