Nwando Mary Olisa

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

702 Russell Ave Ste 100
Gaithersburg, MD 20877-2605

Phone

(301) 330-0006

NPI assigned

Dec 16, 2021

Sex

Female

Sole proprietor

No

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

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NC

  Medicare reassignment

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1548929664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 RUSSELL AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772605",
            "telephone_number": "301-330-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 RUSSELL AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772605",
            "telephone_number": "301-330-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLISA",
        "first_name": "NWANDO",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Oku
• Ganiyat Olasumbo Anike Oladapo, M.D.
• Olde Towne Primary Care LLC
• Olde Towne Urgent Care, LLC
• Olgavarnachevallc
• Shanita Oliver
• Melissa Olsen
• Folake Olubasusi, RN, MSN, FNP-BC
• Paula Oluwaseyi
• Olympus Dental LLC

• Clinical Social Worker in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.