Olukorede Gisanrin

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R192641 Issued in MD

Practice address

9600 Marilyn Ivy CT
Upper Marlboro, MD 20772-4509

Phone

(240) 533-8778

NPI assigned

Aug 28, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Medstar Urgent Care LLC

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1902175870
  Medicare reassignment NPD
• Medstar Urgent Care LLC

  • General Practice Physician
  • Lexington Park, MD
  • NPI 1275410474
  NPD
• Medstar Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Wheaton, MD
  • NPI 1871843409
  NPD

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1548094840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 MARILYN IVY CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207724509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 MARILYN IVY CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207724509",
            "telephone_number": "240-533-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISANRIN",
        "first_name": "OLUKOREDE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R192641",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R192641",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Gibson, CPNP-PC
• Geraldine Gike
• Karen Anita Giles, LCSW-C, LICSW
• Angela Gillian, BEHAVIOR TECHNICIAN
• Naya Gilmore
• Gladell Mental Wellness LLC
• Gladys Healthcare Services
• Jeffrey Glicksman, M.D.
• Glorious Growth Health Care
• Go Stretch

• Family Nurse Practitioner in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.